矛盾性失眠患者睡眠信念与态度分析

Analysis of sleep belief and attitude in patients with paradoxical insomnia

目的探讨矛盾性失眠、原发性失眠患者以及健康人群关于睡眠信念与态度看法的差异。方法根据多导睡眠呼吸监测(PSG)结果和患者当晚主观睡眠时间之间差异纳入矛盾性失眠患者(Par Ⅰ组)28例和原发性失眠患者(PI组)30例,并选取健康对照(对照组)10名,分别进行睡眠个人信念与态度量表(DBAS-16)和匹兹堡睡眠质量指数量表(PSQI)评估。结果Par Ⅰ组和PI组PSQI总分及除睡眠药物使用因子外其他各因子分均高于对照组(P<0.05),Par Ⅰ组和PⅠ组DBAS-16总分及害怕失眠后果、恐惧睡眠因子分均低于对照组(P<0.05)。Par Ⅰ组DBAS-16的恐惧睡眠因子分与PSQI总分呈负相关(P<0.05),DBAS-16睡眠期望因子分与PSQI总分及日间功能因子分均呈负相关(P<0.05)。PI组DBAS-16的害怕失眠后果与PSQI睡眠障碍、日间功能因子分均呈负相关(P<0.05);DBAS-16总分及恐惧睡眠因子分与PSQI总分及日间功能因子分均呈负相关(P<0.05);DBAS-16药物认识因子分与PSQI催眠药物因子分呈负相关(P<0.05)。对照组DBAS-16总分及恐惧睡眠因子分与PSQI睡眠质量因子分呈负相关(P<0.05),DBAS-16总分及害怕失眠后果、睡眠期望因子分与PSQI睡眠持续时间因子分呈正相关(P<0.05)。结论担忧睡眠后果和恐惧失眠是失眠患者的错误睡眠信念,并且与主观性失眠相关。但并未发现矛盾性失眠患者不同于其他失眠组的睡眠信念和认知。

Objective To explore the differences in the beliefs and attitudes about sleep of patients with paradoxical insomnia,primary insomnia and healthy people.Methods A total of 28 patients with paradoxical insomnia(Par Ⅰ group),30 patients with primary insomnia(PI group)and 10 healthy controls(control group)were selected according to the results of polysomnography(PSG)and differences of subjective sleep duration and assessed with Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS-16)and Pittsburgh Sleep Quality Index(PSQI).Results The total scores and all factor scores except sleep drug use factor score of PSQI in Par Ⅰ group and PI group were significantly higher than those in control group(P<0.05).The total scores and factor scores of fear of insomnia consequence and fear of sleep of DBAS-16 in Par Ⅰ group and PI group were all significantly lower than those in control group(P<0.05).The factor score of fear of sleep of DBAS-16 in Par Ⅰ group was negatively correlated with the total score of PSQI(P<0.05),and the factor score of sleep expectation of DBAS-16 was negatively correlated with the total score and factor score of daytime function of PSQI(P<0.05).In PI group,the factor score of fear of insomnia consequence of DBAS-16 was negatively correlated with the factor scores of sleep disorder and daytime function of PSQI(P<0.05);the total score and factor score of fear of sleep of DBAS-16 were negatively correlated with the total score and factor score of daytime function of PSQI(P<0.05);the factor score of medication understanding of DBAS-16 was negatively correlated with the factor score of hypnotic of PSQI(P<0.05).In control group,the total score and factor score of fear of sleep of DBAS-16 were negatively correlated with the factor score of sleep quality of PSQI(P<0.05);the total score and factor scores of fear of insomnia consequence and sleep expectation of DBAS-16 were positively correlated with the factor score of sleep duration of PSQI(P<0.05).Conclusion Worry about sleep consequence and fear of insomnia are the wrong sleep beliefs of insomniacs,which are associated with subjective insomnia.However,there exist no differences in sleep belief and cognition between patients with paradoxical insomnia and those of other insomnia groups.