双相情感障碍患者睡眠状况及影响因素分析

Sleep patterns and factors influencing sleep in patients with bipolar disorder

目的探讨双相情感障碍患者睡眠状况,并分析影响双相情感障碍患者睡眠状况的相关因素,为双相情感障碍患者睡眠的管理提供理论依据。方法选择2018年4月—2022年5月绍兴市第七人民医院住院的149例双相情感障碍患者为研究对象。根据匹兹堡睡眠质量指数量表(PSQI)评分将所有研究对象分为睡眠障碍组和无睡眠障碍组,分析2组患者一般资料和实验室检查结果,采用logistic回归分析研究影响双相情感障碍患者睡眠状况的因素。结果共计发放149份问卷,回收有效问卷142份。其中PSQI评分≥8分为睡眠障碍组(24例),PSQI评分<8分为无睡眠障碍组(118例);142例双相情感障碍患者PSQI总分为(12.09±3.89)分,睡眠质量处于较低水平;睡眠障碍组褪黑素(MLT)、促肾上腺皮质激素(ACTH)均低于无睡眠障碍组,同型半胱氨酸(Hcy)、皮质醇(COR)以及汉密尔顿抑郁量表(HADA)、汉密尔顿焦虑量表(HAMA)评分均高于无睡眠障碍组(P<0.05);高COR(OR=1.444,95%CI:1.127~1.850)、高Hcy(OR=1.875,95%CI:1.154~3.047)均为睡眠障碍发生的危险因素;低ACTH(OR=0.758,95%CI:0.609~0.943)、低MLT(OR=0.794,95%CI:0.700~0.900)均为睡眠障碍发生的保护因素(P<0.05)。结论双相情感障碍均伴有不同程度的睡眠障碍,且MLT、ACTH以及Hcy、COR均为影响患者睡眠状况的相关因素。

Objective This study aims to explore the sleep status of patients with bipolar disorder and analyze the related factors affecting the sleep status of patients with bipolar disorder,and to analyze the related factors,and to provide theoretical basis for the sleep management of patients with bipolar disorder.Methods A total of 149 hospitalized patients with bipolar disorder from April 2018 to May 2022 at Shaoxing Seventh People's Hospital were enrolled in this study.According to their Pittsburgh sleep quality index(PSQI)score,the subjects were divided into two groups:sleep disorder group and non-sleep disorder group.The general data and laboratory test results of both groups were analyzed.Additionally,multivariate stepwise logistic regression with binary variables was conducted to identify factors infulencing the sleep status of patients with bipolar disorder were analyzed by.Results Out of the 149 distributed questionnaires,142 valid questionnaires were collected.Among them,24 participants with a PSQI score≥8 were divided into the sleep disorder group,while 118 participants with a PSQI score<8 were classified into the non-sleep disorder group.The overall PSQI score for the 142 patients with bipolar disorder was(12.09±3.89)points,indicating a low level of sleep quality.In the sleep disorder group,the levels of melatonin(MLT)and adrenocorticotropic hormone(ACTH)were lower than that of the non-sleep disorder group.Conversely,the levels of homocysteine(Hcy)and cortisol(COR),as well as the scores of Hamilton depression scale(HADA)and Hamilton anxiety scale(HAMA),were higher in the non-sleep disorder group(P<0.05).Multivariate logistic regression analysis showed that high COR(OR=1.444,95%CI:1.127-1.850)and high Hcy(OR=1.875,95%CI:1.154-3.047)were risk factors for sleep disorders.Low ACTH(OR=0.758,95%CI:0.609-0.943)and low MLT(OR=0.794,95%CI:0.700-0.900)were all protective factors for sleep disorders(P<0.05).Conclusion Sleep disorders are commonly observed in individuals with bipolar disorder,and several factors including MLT,ACTH,Hcy,and COR are associated with the sleep status of these patients.