职业压力、职业倦怠与睡眠障碍的关系及其分子遗传机制

Job stress can lead to many psychological problems such as depression, job burnout and sleep disturbance. Previous studies have shown that stress can activate HPA axis and affect circadian clock system through changes in cortisol level. Resetting of peripheral circadian clock mediated by cortisol can help organisms deal with stress. How does the job stress as a kind of chronic stress affect sleep quality of occupational population is still unclear. Our preliminary study showed that there were mediating effects of depression and job burnout in the relationship between job stress and sleep disturbance. We choose university faculties and employees of enterprises as subjects and explore two aspects of the relationship between job stress and sleep disturbance. First, we investigate the mediating effects of depression and job burnout on the relationship between job stress and sleep, and the relationships between BDNF, cortisol level in peripheral serum and sleep quality. Another area that we are going to exam is the effect of polymorphism in circadian genes CLOCK, PER2, PER3 and stress-related genes OXTR, COMT, BDNF on stress-related sleep disturbance in working population, and to find out which genetic polymorphisms are more susceptible to sleep problems in individuals. Meanwhile, we will test the treatment effect of practicing mindfulness meditation on sleep disturbance. The present study provides important guidance for preventing sleep disturbances among occupational population.

职业压力引起抑郁、倦怠、睡眠障碍等多种心理问题。已有研究发现压力应激激活HPA轴的同时通过糖皮质激素影响生物节律系统，糖皮质激素介导的外周生物节律的重设有利于机体应对压力。然而职业压力是如何引起睡眠障碍的，其机制并不清楚。我们前期探索性研究发现了抑郁和倦怠在职业压力与睡眠质量之间的中介作用，本课题选取高校教师和企业员工作为被试，从两个方面研究职业压力伴发的倦怠与睡眠障碍的关系，一方面研究职业压力引起的抑郁和倦怠在睡眠变量中的中介作用以及血清皮质醇和BDNF水平与睡眠质量的关系；另一方面研究生物节律相关基因CLOCK、PER2、PER3和压力相关基因OXTR、COMT、BDNF等基因的单核苷酸多态性在职业压力引起睡眠障碍中的作用，找出哪些基因型的人在职业压力下易于出现睡眠障碍。同时选取部分人群进行正念冥想干预并评价效果。本课题的研究对预防职业人群睡眠障碍的发生有一定的理论指导意义。

本课题围绕职业人群的职业压力所致职业倦怠、睡眠质量和抑郁症状等问题开展研究。运用自评量表评估职业压力、职业倦怠、睡眠质量和抑郁症状，对空腹静脉血样本进行DNA提取与基因分析，运用调节和中介等的方法进行统计分析。研究结果显示：（1）职业压力和压力源与睡眠质量呈显著相关。（2）CLOCK、BDNF、OXTR等基因多态性与职业压力的交互作用显著影响睡眠质量和职业倦怠。（3）CLOCK基因多态性rs12649507对抑郁症状无直接影响，但能通过影响睡眠总分来影响抑郁症状。（4）OXTR基因型与基因型的交互作用显著影响睡眠质量与共情。研究结果与发现在丰富相关研究的同时为有效预防职业压力、职业倦怠引起睡眠问题提供科学依据，并为职业人群睡眠问题的早期筛查和干预提供参考。