正念与中老年人睡眠质量的关系及机制研究

摘要/Abstract

摘要： 目的了解中老年人睡眠质量与正念的关系及感知压力和认知重评在其中的作用。方法 2023年3—4月招募中老年人（年龄≥45岁）579名,采用匹兹堡睡眠质量指数（pittsburgh sleep quality index,PSQI）、简版五因素正念觉知量表（short-form five facet mindfulness questionnaire,SF-FFMQ）、中文版感知压力量表（Chinese perceived stress scale,CPSS）、情绪调节量表（emotion regulation scale,ERS）进行问卷调查,并对数据进行分析。结果中老年人的PSQI总分为（11.1±5.1）分,SF-FFMQ总分为（62.9±7.4）分,CPSS总分为（37.1±7.4）分,认知重评总分为（24.0±4.8）分。中老年人SF-FFMQ总分与PSQI总分、CPSS总分均呈负相关（r=-0.25、-0.52,均P<0.01）,CPSS总分与PSQI总分呈正相关（r=0.39,P<0.01）。中老年人的CPSS得分在SF-FFMQ得分与PSQI得分之间起中介作用,中介效应为-0.09,95%CI为-0.13~-0.06;SF-FFMQ得分与认知重评得分的交互作用与CPSS得分（β=-0.07,P<0.05）及PSQI得分负向关联（β=-0.10,P<0.01）,认知重评得分调节了CPSS得分在SF-FFMQ得分与PSQI得分之间的中介效应,即在低认知重评得分时（-1s）,CPSS得分的间接效应为-0.06,95%CI为 -0.11~-0.03,而在高认知重评下（+1s）,CPSS得分的间接效应为-0.09,95%CI为0.14~-0.04。结论中老年人的正念水平可以直接预测睡眠质量,也可以通过感知压力间接预测睡眠质量;认知重评不仅在正念水平和睡眠质量之间起调节效应,在感知压力的中介作用中也起到调节效应。提高正念水平、认知重评能力,减少感知压力有利于促进中老年人的睡眠质量。

关键词: 正念, 睡眠质量, 感知压力, 认知重评, 中老年人

Abstract: Objective To investigate the relationship between mindfulness and sleep quality of middle-aged and elderly people as well as the roles of perceived stress and cognitive reappraisal. Methods From March to April of 2023,579 middle-aged and elderly people（age ≥45 years old） were enrolled and measured with Pittsburgh sleep quality index（PSQI）,short-form five facet mindfulness questionnaire（SF-FFMQ）,Chinese perceived stress scale（CPSS） and emotion regulation scale（ERS）,and the data were analyzed. Results The total PSQI score of middle-aged and elderly people was （11.1±5.1）points,the total score of SF-FFMQ was （62.9±7.4）points,the total score of CPSS was （37.1±7.4）points,and the total score of cognitive reappraisal was （24.0±4.8）points. The total score of SF-FFMQ in middle-aged and elderly people was negatively correlated with the total score of PSQI and the total score of CPSS（r=-0.25,-0.52,both P<0.01）. The total score of CPSS was positively correlated with the total score of PSQI（r=0.39,P<0.01）. The CPSS scores of middle-aged and elderly people played a mediating role between SF-FFMQ scores and PSQI scores,the mediating effect was -0.09,and 95%CI was -0.13--0.06. The interaction effects of SF-FFMQ score and cognitive reappraisal score were negatively related to CPSS score（β=-0.07,P<0.05） and PSQI score（β=-0.10,P<0.01）,the cognitive reappraisal score moderated the mesomeric effect of CPSS score between SF-FFMQ score and PSQI score,that is,when the cognitive reappraisal score was low（-1s）,the indirect effect of CPSS score was -0.06,and 95%CI was -0.11--0.03,but when the cognitive reappraisal score was high（+1s）,the indirect effect of CPSS score was -0.09,and 95%CI was 0.14--0.04. Conclusions The mindfulness level of middle-aged and elderly people can directly predict sleep quality,and can also indirectly predict sleep through perceived stress. The cognitive reappraisal not only mediates the relationship between mindfulness level and sleep quality,but also plays a regulatory role in the mediating effect of perceived stress. Improving mindfulness levels and cognitive reappraisal abilities,and reducing perceived stress are beneficial to promoting sleep quality of middle-aged and elderly people.

Key words: Mindfulness, Sleep quality, Perceived stress, Cognitive reappraisal, Middle-aged and elderly people

中图分类号:

R395.6

李海红, 张镇, 韩智其, 周航. 正念与中老年人睡眠质量的关系及机制研究. [J]职业与健康, 2024, 40(14): 1931-1936.

LI Haihong, ZHANG Zhen, HAN Zhiqi, ZHOU Hang. Study on relationship and mechanism between mindfulness and sleep quality of middle-aged and elderly people. [J]OCCUPATION AND HEALTH, 2024, 40(14): 1931-1936.

参考文献

[1] GOLDEN A,TWERY M,HUNT C E.National center on sleep disorders research[J].Sleep Med,2004,5(1):83-85.
[2] 孙文韬,栗克清.河北省中年人睡眠质量及生活方式、生活习惯因素的影响分析[J].现代预防医学,2020,47(8):1451-1455.
[3] 林秀玲,徐艳,杨婧,等.727例老年人睡眠质量及影响因素调查分析[J].世界睡眠医学杂志,2023,10(1):45-47.
[4] KABAT-ZINN J.Mindfulness-based interventions in context:Past,present,and future[J].Clin Psychol Sci,2003,10(2):144-156.
[5] 孙伟. 失眠疗愈[M].西安:世界图书出版西安有限公司,2022:10-11.
[6] 胡雨葳,张吉,马靖,等.正念对大学生睡眠质量的影响:消极注意偏向与就寝拖延行为的链式中介作用[J].中国健康心理学杂志,2023, 31(5):796-800.
[7] 靳宇倡,王雅楠,安俊秀.员工觉知压力对睡眠质量的影响:正念的调节作用及焦虑的中介作用[J].心理科学,2022,45(2):433-438.
[8] 蔡悦,唐莉玲.正念冥想联合eCBTI干预孕妇睡眠障碍的研究[J].现代中西医结合杂志,2022,31(2):269-273.
[9] SPIELMAN A J,CARUSO L S,GLOVINSKY P B.A behavioral perspective on insomnia treatment[J].Psychiatr Clin North Am,1987,10(4):541-553.
[10] O'LOUGHLIN E R,FRYER W J,ZUCKERMAN M.Mindfulness and stress appraisals mediate the effect of neuroticism on physical health[J].Personal Indiv Diff,2019,142:122-131.
[11] ULMER C S,STETSON B A,SALMON P G.Mindfulness and acceptance are associated with exercise maintenance in YMCA exercisers[J].Behav Res Ther,2010,48(8):805-809.
[12] 张妍,李飞,王志寰,等.硕士生压力知觉、状态-特质焦虑、完美主义与睡眠质量的关系[J].心理科学,2014,37(6):1409-1414.
[13] 孙宏超. 正念训练对难治性抑郁症患者抑郁程度、知觉压力及睡眠质量的影响[J].世界睡眠医学杂志,2023,10(2):326-328,332.
[14] 赵玲玲,马冬冬,任雁北,等.冠心病患者心理弹性在感知压力与睡眠质量关系间的中介作用[J].中国实用护理杂志,2018,34(23):1761-1765.
[15] GROSS J J,JOHN O P.Individual differences in two emotion regulation processes:Implications for affect,relationships,and well-being[J].J Pers Soc Psychol,2003,85(2):348-362.
[16] ALDAO A,NOLEN-HOEKSEMA S,SCHWEIZER S.Emotion-regulation strategies across psychopathology:A meta-analytic review[J].Clin Psychol Rev,2010,30(2):217-237.
[17] ANTJE R,CAROLIN W,CZ R,et al.Positive cognitive reappraisal in stress resilience,mental health,and well-being:A comprehensive systematic review[J].Emot Rev,2022,14(4):310-331.
[18] RUDAZ M,TWOHIG M P,ONG C W,et al.Mindfulness and acceptance-based trainings for fostering self-care and reducing stress in mental health professionals:A systematic review[J].J Contextual Behav Sci,2017,6(4):380-390.
[19] 张瑶瑶,郭成,袁宏,等.正念对压力的影响——基于监控与接纳理论[J].心理科学,2022,45(6):1492-1499.
[20] 郭晓栋,郑泓,阮盾,等.认知和情感共情与负性情绪:情绪调节的作用机制[J].心理学报,2023,55(6):892-904.
[21] 程利,袁加锦,何媛媛,等.情绪调节策略:认知重评优于表达抑制[J].心理科学进展,2009,17(4):730-735.
[22] 吴圣贤,王成祥.临床研究样本含量估算[M].北京:人民卫生出版社,2008:79-80.
[23] 熊风,赖玉清,涂嘉欣,等.中国老年人群睡眠障碍流行特征的Meta分析[J].中国循证医学杂志,2019,19(4):398-403.
[24] 刘贤臣,唐茂芹,胡蕾,等.匹玆堡睡眠质量指数的信度和效度研究[J].中华精神科杂志,1996,29(2):103-107.
[25] MENG Y,MAO K,LI C.Validation of a short-form five facet mindfulness questionnaire instrument in China[J].Front Psychol,2020,10:30-31.
[26] SHI C,GUO Y,MA H,et al.Psychometric validation of the 14-item perceived stress scale in Chinese medical residents[J].Curr Psychol,2019,38(1):7.
[27] 陈程,刘晓宇,宋静,等.人际情绪调节问卷在中国大学生中的信效度检验[J].中国健康心理学杂志,2021,29(11):1684-1688.
[28] 温忠麟,叶宝娟.有调节的中介模型检验方法:竞争还是替补?[J].心理学报,2014,46(5):714-726.
[29] 周浩,龙立荣.共同方法偏差的统计检验与控制方法[J].心理科学进展,2004,12(6):942-950.
[30] 徐世才,彭洁,袁铭,等.正念疗法对养老机构老年人睡眠质量和认知功能的影响[J].中国健康教育,2020,36(7):667-669.
[31] COLM L,CAOIMHE H,MCHUGH J P,et al.The effect of mindfulness-based intervention on cognitively unimpaired older adults' cognitive function and sleep quality:A systematic review and meta-analysis[J].Aging Mental Health,2023:11-13.
[32] LUDERS E,TOGA W A,LEPORE N,et al.The underlying anatomical correlates of long-term meditation:Larger hippocampal and frontal volumes of gray matter[J].NeuroImage,2009,45(3):672-678.
[33] ERIC J L,MICHELLE V,PHILIP J M,et al.Effects of mindfulness training and exercise on cognitive function in older adults:A randomized clinical trial[J].JAMA,2022,328(22):2218-2219.
[34] 王芹,章新琼,王秋萍,等.正念减压法对癌症患者知觉压力与睡眠障碍干预效果的系统评价[J].重庆医学,2017,46(25):3547-3550.
[35] CUTULI D.Cognitive reappraisal and expressive suppression strategies role in the emotion regulation:An overview on their modulatory effects and neural correlates[J].Front Syst Neurosci,2014,8:175.
[36] 王汉林,李博文,任维聪.短时正念训练对大学生负性情绪唤醒度的效应[J].中国心理卫生杂志,2023,37(9):801-806.