短睡眠67例误诊为慢性失眠原因探讨

The Cause of Short Sleep Misdiagnosed as Chronic Insomnia(a Report of 67 Cases)

目的探讨短睡眠误诊为慢性失眠的原因,提出防范误诊的对策。方法对短睡眠67例的临床资料进行回顾性分析。结果 67例均误诊为慢性失眠,病史均为不同程度的睡眠质量差,表现为早醒、睡眠浅、多梦、睡眠时间短,白天无或仅有轻微的日间功能下降。匹兹堡睡眠质量指数(PSQI)平均16.3分,焦虑自评量表(SAS)平均59.7分,抑郁自评量表(SDS)平均56.2分,修正诊断为慢性失眠。均予睡眠行为认知疗法,19例焦虑、抑郁较重者予抗焦虑、抑郁药物治疗,6个月内停药。结论对诊断为慢性失眠者,应对其日间功能和睡眠健康知识水平及其情绪变化进行评估,避免误诊误治。

Objective To explore the cause of short sleep misdiagnosed as chronic insomnia.Methods The clinical data of 67 patients with short sleep were retrospectively analyzed.Results 67 patients were all misdiagnosed as having chronic insomnia,presenting poor sleep quality,early awakening,insufficient sleep,dreaminess,short bedtime,without descending daily function or only with slight descending daily function.The average score of Pittsburgh Sleep Quality Index（PSQI） was 16.3,self-rating anxiety scale（SAS） was 59.7,and self-rating depression scale（SDS） was 56.2,and the diagnosis was corrected as short sleep.All the patients received sleep behavior cognitive therapy,and 19 patients with severe anxiety and depression received antianxietic and antidepressant drug,and withdrawed in 6 months.Conclusion When a patient is diagnosed as having short sleep,daily function should be observed and emotional changes and healthy sleep knowledge should be evaluated to avoid misdiagnosis.