门诊慢性失眠障碍合并不宁腿综合征的共病分析

Analysis of comorbidity of chronic insomnia disorder with restless legs syndrome in outpatient clinic

目的探讨门诊慢性失眠障碍（CID）合并不宁腿综合征（RLS）患者的共病特征。方法收集神经内科睡眠门诊就诊的CID连续病例，记录患者的一般资料、CID病因、RLS症状学调查及RLS严重程度量表，比较CID伴RLS（CID＋RLS）组和CID不伴RLS（CID—RLS）组失眠病因构成的差异。结果连续入组122例，5例因不能配合问卷调查而剔除，实际纳入117例。50例（42．7％）合并两种或以上病因。精神心理障碍所致失眠、躯体问题所致失眠和心理生理性失眠分别为50例（42．7％）、41例（35．0％）和32例（27．4％）。33例（28．2％）合并其他睡眠障碍，其中RLS30例（25．6％）。与CID—RLS组相比，CID＋RLS组其他躯体问题所致失眠的比例较高，睡眠卫生习惯不良和器质性病因待定失眠的比例较少，分别为（40．0％比12．6％，P=0．001），（3．3％比18．4％，P=0．044）和（0％比13．8％，P=0．032）。结论神经内科门诊近半数CID患者合并两种或两种以上病因，CID常见病因是精神心理障碍所致失眠、躯体问题所致失眠和心理生理性失眠等。CID伴RLS和不伴RLS的病因构成有明显差异。

Objective To explore the characteristics of comorbidity of chronic insomnia disorder（CID）and restless legs syndrome（RLS）.Methods A consecutive case series of CID were enrolled into the study.The patients＇ general information,etiological subtype,RLS symptoms investigation and RLS symptom severity scale were recorded.All patients were divided into CID with RLS group（CID＋RLS）and CID without RLS group（CID-RLS）,and the distribution of etiological subtype was compared between two groups.Results 117 eases of CID were enrolled from 122 consecutive cases,the other 5 cases were eliminated because of unable cooperation.50 eases（42.7%）comorbided two or more etiological subtypes.The incidences of insomnia due to mental disorders,insomnia due to medical disorders,psychological physiology insomnia were 50（42.7%）,41（35.0%）and 32（27.4%）respectively.Insomnia due to other sleep disorder were 33（28.2%）,30 cases of which（25.6%）were for RLS.Compared with the CID-RLS group,CID＋RLS group had insomnia more due to medical disorders（40.0% vs 12.6%,P=O.001）,CID＋RLS group had insomnia less due to poor sleep hygiene,physiologic insomnia,and unspecified（3.3% vs 18.4%,P=0.044;0% vs 13.8%,P=0.032）.Conclusions In the Neurological outpatients,nearly half comorbid two or more kinds of subtypes.It is more common to have insomnia due to mental disorders,medical disorders and psychological physiology insomnia among CID outpatients.The subtypes of two groups are significantly different.