原发性失眠人群特征、睡眠质量及危险因素的研究

Study on sociodemographic characteristics, sleep quality, and risk factors in population with primary insomnia

目的探讨原发性失眠患者的人群特征、睡眠质量及心理健康状况,探索原发性失眠可能的危险因素。方法采用基于病例对照的研究设计,对602例原发性失眠患者和242例年龄、性别相匹配的健康志愿者进行匹兹堡睡眠质量指数问卷（PSQI）、汉密尔顿抑郁量表17项（HAMD-17）、汉密尔顿焦虑量表（HAMA）的评估以及生活习惯和方式的比较。结果原发性失眠患者和健康对照组在教育水平、婚姻、居住情况、职业收入、生活习惯、睡眠习惯、家庭关系、存在躯体不适以及心理健康状况方面差异有统计学意义（P〈0.05）。病例组PSQI各项目得分、总分均高于对照组,差异有统计学意义（P〈0.01）;与男性失眠患者相比,女性失眠患者入睡所需时间更长,睡眠效率较差,更容易使用催眠药物（P〈0.05）。通过Logistic回归分析发现,饮酒、存在躯体不适、加班或夜班、离异或丧偶、个人年收入（$5万~10万）、精神心理因素（焦虑、抑郁）都是失眠的危险因素。结论原发性失眠患者多伴有躯体不适以及焦虑或抑郁症状。饮酒、加班或夜班、离异或丧偶、个人年收入（$5万~10万）等都可能是失眠的危险因素。

Objective To explore sociodemographic characteristics, sleep quality, and mental health in patients with prim ary insom nia and investigate possible risk factors for prim ary insom nia. Methods A case-control study w as em ployed. A total of 602 patients with prim ary insom nia and 242 healthy controls with m atched age and sex were surveyed with Pittsburgh Sleep Q uality Index（ PSQ I）, Ham ilton Depression Rating Scale-17（ H AM D-17）, H am ilton Anxiety Scale（ H AM A） and their habits and life style were com pared. Results The differences in education, maritalstatus, housing conditions, incom e, life and sleeping habits, fam ily relationship, som atic discom fort, and m ental health betw een patients with prim ary insom nia and healthy controls were statistically significant（ P 〈0. 05）. Item scores and the total score of PSQ I were higher in the patients with prim ary insom nia as com pared with the controls and the differences were statistically significant（ P〈 0. 01）.Fem ale patients show ed a longer sleep latency, poorer sleep efficiency, m uch easier to use sleeping medications as com pared with m ale patients（ P 〈0. 05）. Logistic regression analysis revealed that alcohol consum ption, som atic discomfort, work overtime or night shift, divorced or widowed, individual annual income（ ￥ 50 000- 100 000）,and m ental health（ anxiety, depression） were risk factors for prim aryinsomnia. Conclusion Patients with prim ary insomnia is com m only associated with som atic discom fort and sym ptom s of anxiety or depression.Alcohol consum ption, work overtim e or night shift, divorced or widow ed, and individual annual income（ ￥ 50 000- 100 000） m ay be possible risk factors for primary insomnia.