慢性失眠对跨期决策行为的影响

The Influence of Chronic Insomnia on Intertemporal Decision-Making Behavior

摘要: 目的：本研究旨在探究慢性失眠障碍(CID)对跨期决策行为的影响，为睡眠干预改善决策提供理论与实践依据。方法：选取2024年1月至2025年8月合肥市第一人民医院门诊及住院的35例CID患者作为慢性失眠组，以及30例年龄、性别、受教育年限相匹配的健康人群作为睡眠良好组。通过匹兹堡睡眠质量指数量表(PSQI)、Epworth嗜睡量表(ESS)等临床症状量表评估睡眠、疲劳、情绪等状况；运用数字广度(DS)、连线任务(TMT)等神经心理学测试评估认知、执行功能；跨期选择、延迟折扣、价值评估等中文版实验范式评估跨期决策能力。结果：慢性失眠组PSQI、ESS、FSS、ISI、HAS、SDS、SAS评分均显著高于睡眠良好组(p < 0.05)；神经心理学测试中，慢性失眠组在数字连线任务A (p = 0.026)、数字广度顺背(p = 0.012)及逆背(p = 0.017)任务表现显著差于睡眠良好组；跨期决策方面，慢性失眠组在跨期选择任务的now实验和not-now实验中即时偏好显著(p < 0.05)，延迟折扣任务K值(0.0487 ± 0.0715)显著高于睡眠良好组(0.0101 ± 0.0323, p = 0.006)，价值评估任务两组无显著差异(p > 0.05)。Pearson相关分析结果显示慢性失眠组K值与PSQI、ESS、ISS、SDS、SAS呈正相关(p < 0.05)，与FSS、HAS、数字连线、数字广度任务相关性不显著。结论：慢性失眠患者存在工作记忆与执行功能损害，慢性失眠会导致跨期决策能力受损。

Abstract: Objective: This study aims to explore the impact of chronic insomnia disorder (CID) on intertemporal decision-making behavior and provide a theoretical and practical basis for sleep intervention to improve decision-making. Methods: Thirty-five patients with CID who were outpatients and inpatients of the First People’s Hospital of Hefei from January 2024 to August 2025 were selected as the chronic insomnia group, and 30 healthy people with matched age, gender, and years of education were selected as the good sleep group. Sleep, fatigue, mood, and other conditions were evaluated through clinical symptom scales such as the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Cognitive and executive functions are evaluated using neuropsychological tests such as Number Span (DS) and connect-Task (TMT). Chinese experimental paradigms such as intertemporal selection, delayed discount, and value assessment are used to evaluate intertemporal decision-making capabilities. Results: The scores of PSQI, ESS, FSS, ISI, HAS, SDS, and SAS in the chronic insomnia group were significantly higher than those in the good sleep group (p < 0.05). In the neuropsychological test, the chronic insomnia group performed significantly worse than the group with good sleep in the tasks of the number connection task A (p = 0.026), number breadth forward memorization (p = 0.012), and backward memorization (p = 0.017). In terms of intertemporal decision-making, the chronic insomnia group had a significant immediate preference in the now experiment and the not-now experiment of the intertemporal selection task (p < 0.05), and the K value of the delayed discounting task (0.0487 ± 0.0715) was significantly higher than that of the good sleep group (0.0101 ± 0.0323, p = 0.006). There was no significant difference in the value assessment tasks between the two groups (p > 0.05). The results of Pearson correlation analysis showed that the K value in the chronic insomnia group was positively correlated with PSQI, ESS, ISS, SDS, and SAS (p < 0.05), but not significantly correlated with FSS, HAS, digital connection, and digital breadth tasks. Conclusion: Patients with chronic insomnia have impairments in working memory and executive function. Chronic insomnia can lead to impaired intertemporal decision-making ability.