老年高血压患者睡眠的健康行为干预

A Behavior Intervention on Sleep of Elderly Patients with Hypertension

目的探讨健康行为干预对老年高血压患者伴失眠问题的干预疗效。方法将108例老年高血压伴失眠患者随机分为治疗组、对照组1和对照组2,在基线分别施行综合认知行为治疗干预、单纯的睡眠卫生教育以及等待行为治疗,并分别在干预前后进行匹兹堡睡眠质量指数评定,以及评估干预后3组间收缩压及脉压指数的差异。结果治疗组干预后PSQI中主观睡眠质量、入睡时间、睡眠效率、睡眠障碍、催眠药物和PSQI总分差异均有统计学意义(P<0.05);此外还发现治疗组干预后收缩压和脉压指数比干预前明显降低[(150.83±7.70)mm Hg vs.(145.89±7.72)mm Hg,(0.50±0.04)vs.(0.48±0.36)],差异均有统计学意义(P<0.01)。结论老年高血压伴失眠患者通过健康行为的认知干预能改善老年高血压的睡眠障碍,比单纯的睡眠卫生教育更有效;此外认知行为综合治疗使老年高血压睡眠障碍患者的收缩压和脉压指数有所下降。

Objective To understand the effects of behavior intervention on insomnia of elderly patients with hypertension. Methods 108 elderly hypertension patients of insomnia were randomly divided into the treatment group （ CCBT, Comprehensive cognitive behavioral therapy group）, the single treatment group （SHE, Sleep health education） and the control group after the baseline study. All the patients were evaluated with Pittsburgh Sleep Quality Index （PSQI） before and after the intervention, differences of SBP and pulse pressure index （PPI） among three groups were also assessed. Results Differences by PSQI measurement of sleep efficiency, sleep disorders and hypnotics compositionin CCBT group between before and after intervention had statistical significances, as well as sleep quality, time for falling asleep and PSQI total points had same results in CCBT group. In addition, obvious declination was found in SBP and pulse pressure index （PPI） of CCBT group after treatment; the differences had statistical significance （ P 〈 0. 01 ）. Conclusion Sleep disorders of elderly hypertension patients could be improved through behavior intervention which was much more effective than sleep health education only. In addition, SBP and pulse pressure index （PPI） of elderly patients with hypertension and sleep disorders could be reduced through cognitive behavioral comprehensive therapy.