心理应激性失眠患者主客观睡眠特征分析

Characteristic analysis of subjective and objective sleep in patients with insomnia subsequent to psychological stress

目的:探讨心理应激性失眠患者的主、客观睡眠特征及其差异,为心理应激性失眠的治疗提供依据。方法:采用匹兹堡睡眠质量指数量表(PSQI)及睡眠自评量表(SRSS)对43例心理应激性失眠患者的主观睡眠质量进行评估,同时通过多导睡眠监测(PSG)对患者的客观睡眠质量进行评定。结果:心理应激性失眠患者PSQI和SRSS分别为(14.0±3.2)分和(32.4±5.0)分,均显著高于我国常模7分和(22.1±5.5)分。与PSG睡眠参数常模比较,总睡眠时间(TST)、睡眠潜伏期(SL)、各睡眠时相、睡眠结构短觉醒次数均在正常范围内,但长觉醒次数(9.7±4.7)次较常模5次明显增多;主观SL(55.7±52.7)min,较客观SL(18.8±20.0)min显著为长(t=-4.619,P=0.001);主观TST(306.3±113.1)min,较客观TST(376.8±46.7)min显著为短(t=-3.764,P<0.001)。结论:心理应激性失眠患者存在睡眠状态感知不良,具有高估SL,低估TST的特点。

Objective： To investigate the characteristics of subjective and objective sleep in patients with insomnia subsequent to psychological stress and their differences, thus providing evidence for the treatment. Method：43 insomnia patients subsequent to psychological stress were evaluated their qualities of subjective sleep by pittsburgh sleep quality index （PSQI） and self-rating scale of sleep （SRSS） , meanwhile characteristics of objective sleep being assessed by polysomnography （PSG）. Results：The score of PSQI and SRSS in these patients were （ 14.0 ± 3.2） and （ 32.4 ± 5.0） , respectively, which significantly higher than the cut-off score of insomnia （ 〉 7 ） and the score of domestic norm, （22.1 ± 5.5）. The total sleep time（ TST）, sleep latency（SL） , sleep phase, sleep frame and times of short waking up were in normal range compared with the norm of PSG. However, the times of long waking up（ 9.7 ±4.7） was significantly more than the norm （5）. The latency of subjective sleep was （ 55.7 ± 52.7 ） min, significantly longer than the objective one （ 18.8 ± 20.0） min （ t = - 4. 619, P = 0.001 ） ; the total subjective sleep time was （306.3 ± 113.1 ） min, markedly shorter than the objective one （376.8 ±46.7） min （t = -3. 764, P 〈0. 001 ）. Conclusion：The insomnia patients subsequent to psychological stress had disorder in perception of sleep state, with the characteristics of overestimating the SL and underestimating the TST.