海洛因依赖者多导睡眠图与主观评估对比分析

Comparative analysis of subjective estimation and polysomnography of sleep in heroine dependence patients

目的:探讨海洛因依赖者美沙酮替代治疗早期的主客观睡眠特征。方法:选择20例美沙酮替代治疗早期的海洛因依赖者(海洛因依赖组)和20名正常人为对照(对照组),进行全夜多导睡眠图(PSG)的监测,以评估受试者的客观睡眠状况;采用匹兹堡睡眠质量指数问卷(PSQI)、爱泼沃斯嗜睡评分量表(ESS)评估受试者的主观睡眠状况。结果:与对照组比较,海洛因依赖组主客观睡眠时间缩短,睡眠效率降低,主观入睡潜伏期延长(P<0.01);主观睡眠时间、入睡潜伏期、睡眠效率与PSG检测结果差异有统计学意义(P<0.01);海洛因依赖组PSQI及ESS评分均显著高于对照组(P<0.01)。ESS评分与慢波睡眠的减少呈显著负相关(r=-0.614,P=0.004)。结论:海洛因依赖者美沙酮替代治疗早期睡眠质量差,主客观睡眠评估不一致,患者白天困倦感与慢波睡眠减少相关。

Objective：To investigate the subjective and objective characteristics of sleep with heroin dependent patients in methadone maintain treatment. Method：20 heroine dependent patients （heroine dependent group） and 20 normal controls （control group） were recruited, using overnight polysomnography （PSG） to assess the objective sleep. Also the subjective sleep was rated with Pittsburgh sleep quality index （PSQI） and Epworth sleepiness scale （ ESS ）. Results ： Compared with normal controls, the patients heroine dependent group had shortened sleep time, low sleep efficiency and subjective perception of prolonged sleep latency （ P 〈 0.01 ）. The sleep latency,total sleep time and sleep efficiency acquired from subjective estimation were signifi- cantly inconsistent with the results of polysomnography （ P 〈 0.01 ）. The PSQI and ESS scores in the heroine dependent group were significantly higher than the controls （ P 〈 0.01 ）, and ESS scores of the patients had an inverse correlation with slow wave sleep （ r = - 0. 614, P = 0. 004 ）. Conclusion ： Heroin dependent patients have poorer sleep quality, and subjective estimation of sleep is worse than the results of PSG. The daytime sleepiness may due to the decrease of slow wave sleep.