原发性失眠症患者日间疲劳症状和过度觉醒的关系

Relationship of daytime fatigue and hyperarousal in patients with primary insomnia

目的 探讨原发性失眠症患者日间疲劳症状和过度觉醒的关系.方法 使用问卷法,调查2013年11月至2014年10月期间,中山大学附属第三医院精神科门诊168例原发性失眠症患者和149名健康对照者.分别采用过度觉醒量表、睡前觉醒量表、疲劳量表-14和视觉模拟评分表来评价入组者过度觉醒特质、睡前觉醒程度、日间疲劳及总体睡眠质量.结果 研究组过度觉醒分[（41.9±9.7）分比（27.6±7.0）分]、睡前觉醒分[（42.0±7.3）分比（22.1±4.7）分],疲劳-14分[（9.2±3.1）分比（3.0±0.7）分]均高于健康对照组,差异有统计学意义（P＜0.001）;以疲劳分为因变量,对其可能影响因素进行回归分析,结果显示,总体睡眠质量影响最大,过度觉醒特质、睡前觉醒程度也与日间疲劳密切相关.结论 过度觉醒是影响原发性失眠患者日间疲劳症状的重要因素之一,需要给予更多的临床关注.

Objective To study the relationship between daytime fatigue and hyperarousal in patients with primary insomnia.Methods One hundred and sixty eighty patients with primary insomnia as research group and 149 healthy people as control group were recruited during November 2013 to December 2014 in the psychiatry department of the Third Affiliated Hospital,Sun Yat-sen University.The Hyperarousal Scale （HAS）,Pre-Sleep Arousal Scale （PSAS）,Fatigue scale-14 （FS-14） and a visual analogue scale （VAS） were used to evaluate the symptom of hyperarousal trait,pre-sleep arousal,daytime fatigue and self reported sleep quality respectively.Results The participants in research group had more severe symptoms of hyperarousal trait [（41.9 ± 9.7） vs （27.6 ± 7.0）],pre-sleep arousal [（42.0 ± 7.3） vs （22.1 ±4.7）],daytime fatigue[（9.2 ±3.1） vs （3.0 ±0.7）] than those in control group.According the multiple linear regressions,the daytime fatigue in research group was positively related not only to sleep quality,but also to hyperarousal trait and pre-sleep arousal.Conclusion Hyperarousal is an important factor which could affect the daytime fatigue in patients with primary insomnia and should be given more attention to.