老年慢性阻塞性肺疾病患者睡眠障碍情况及影响因素分析

Analysis of status and influencing factors of sleep disorders in elderly patients with chronic obstructive pulmonary disease

目的 探讨老年慢性阻塞性肺疾病(COPD)患者睡眠障碍情况并分析其影响因素。方法 选取我院老年科收治的老年COPD患者132例,均经匹兹堡睡眠质量指数(PSQI)调查睡眠状态,并比较睡眠障碍者(PSQI>7分)与无睡眠障碍者(PSQI≤7分)的临床差异,分析影响睡眠障碍的因素。结果 132例老年COPD患者PSQI总分为(5.89±2.81)分,睡眠障碍者49例(37.12%);与常模相比,老年COPD患者PSQI总分及各因子评分明显更高(P<0.05);与无睡眠障碍者相比,睡眠障碍者目前吸烟、GOLD分级Ⅲ~Ⅳ级、近1年急性加重≥2次、长期卧床、呼吸困难高级别、存在夜间症状的比例更高P<0.05);高GOLD分级、长期卧床、高呼吸困难分级、有夜间症状是影响老年COPD患者出现睡眠障碍的影响因素(P<0.05)。结论 老年COPD患者睡眠质量普遍较差,存在较高比例睡眠障碍情况,睡眠障碍受GOLD分级、长期卧床、呼吸困难分级、夜间症状因素影响,应针对以上因素采取积极对策提高患者睡眠质量。

Objective To investigate the status and influencing factors of sleep disorders in elderly patients with chronic obstructive pulmonary disease(COPD).Methods One hundred and thirty-two elderly patients with COPD treated at department of geriatrics inour hospital were selected. The sleep status of the patients was investigated by using Pittsburgh Sleep Quality Index(PSQI) scale. The clinical differences between patients with sleep disorders(PSQI>7 points) and patients without sleep disorders(PSQI≤7 points)were compared. The influencing factors of sleep disorders were analyzed.Results The total PSQI score of 132 elderly patients with COPD was 5.89±2.81 points, and there were 49 patients with sleep disorders, accounting for 37.12%. Compared with the norm, the total score and each factor score of PSQI in elderly patients with COPD were significantly higher(P<0.05). The proportions of patients with current smoking status, GOLD grade III-IV, acute exacerbations ≥ twice in the past 1 year, long-term bed rest, high-grade dyspnea and nocturnal symptoms in patients with sleep disorders were significantly higher than those in patients without sleep disorders(P<0.05). Logistic regression analysis showed that high GOLD grade, long-term bed rest, high dyspnea grade and nocturnal symptoms were the influencing factors of sleep disorders in elderly patients with COPD(P<0.05).Conclusions The sleep quality is poor and incidence rate of sleep disorders is high among elderly patients with COPD. The sleep disorders are affected by GOLD grade, long-term bed rest, dyspnea grade and nocturnal symptoms. It is necessary to take active countermeasures according to the above factors so as to enhance the sleep quality of the patients.