COPD病人睡眠障碍发生率及其影响因素的Meta分析

The incidence and influencing factors of sleep disorders in COPD patients:a Meta-analysis

目的:系统评价慢性阻塞性肺疾病(COPD)病人睡眠障碍的影响因素,为早期识别和干预病人睡眠剥夺、提高病人应对能力提供依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science、the Cochrane Library数据库中关于COPD病人睡眠障碍影响因素的相关文献,检索时限为建库至2023年5月4日。结果:共纳入13篇文献,睡眠障碍发生率为52%,其中呼吸困难指数(mMRC)≥2分[OR=2.01,95%CI(1.14,3.53),P<0.05]、COPD病人自我评估测试(CAT)≥10分[OR=1.24,95%CI(1.01,1.53),P<0.05]、肺功能评估(GOLD)分级Ⅲ~Ⅳ级[OR=2.76,95%CI(1.64,4.65),P<0.05]、合并阻塞性睡眠呼吸暂停后通气综合征(OSA)[OR=2.12,95%CI(1.64,2.74),P<0.05]、疲乏[OR=4.56,95%CI(2.47,8.43),P<0.05]、焦虑[OR=1.13,95%CI(1.07,1.18),P<0.05]、抑郁[OR=1.25,95%CI(1.09,1.45),P<0.05]、长期卧床[OR=2.18,95%CI(1.43,3.32),P<0.05]是COPD病人睡眠障碍的主要影响因素。结论:现有证据表明,COPD病人睡眠障碍发生率较高,mMRC≥2分、CAT≥10分、GOLD分级Ⅲ~Ⅳ级、合并OSA、疲乏、焦虑、抑郁、长期卧床是COPD病人睡眠障碍的主要影响因素。

Objective:To systematically evaluate the influencing factors of sleep disorders in patients with chronic obstructive pulmonary disease(COPD),and provide a basis for early identification and intervention of sleep deprivation and improvement of patient coping ability.Methods:Retrieved relevant literature on the influencing factors of sleep disorders in COPD patients from CNKI,WanFang Database,VIP database,CBM,PubMed,EMbase,Web of Science,and the Cochrane Library.The retrieval time was from the inception to May 4,2023.Results:A total of 13 articles were included,and the incidence of sleep disorders was 52%.Among them,the respiratory distress index(mMRC)was≥2 points(OR=2.01,95%CI 1.14-3.53,P<0.05),the self-evaluation test(CAT)of COPD patients was≥10 points(OR=1.24,95%CI 1.01-1.53,P<0.05),the pulmonary function assessment(GOLD)was graded as gradeⅢ-Ⅳ(OR=2.76,95%CI 1.64-4.65,P<0.05),and the comorbid obstructive sleep apnea hypopnea syndrome(OSA)(OR=2.12,95%CI 1.64-2.74,P<0.05),fatigue(OR=4.56,95%CI 2.47-8.43,P<0.05),anxiety(OR=1.13,95%CI 1.07-1.18,P<0.05),depression(OR=1.25,95%CI 1.09-1.45,P<0.05),and long-term bed rest(OR=2.18,95%CI 1.43-3.32,P<0.05)were the main influencing factors of sleep disorders in COPD patients.Conclusion:Current evidence suggests that COPD patients have a higher incidence of sleep disorders,with mMRC≥2,CAT≥10,GOLD gradesⅢ-Ⅳ,comorbidities with OSA,fatigue,anxiety,depression,and long-term bed rest being the main influencing factors for sleep disorders in COPD patients.