慢性失眠患者睡眠反应性和抑郁焦虑水平与主客观睡眠质量间相关性研究

Study on Correlation of Sleep Reactivity,Depression and Anxiety Level with Sleep Quality in Patients with Chronic Insomnia

为探讨慢性失眠(CI)患者睡眠反应性、睡前觉醒、压力和抑郁焦虑水平改变及和主客观睡眠质量间的关系,招募88名志愿者,分为CI组(61例)和对照组(27例),采用匹兹堡睡眠质量指数(PSQI)、多导睡眠图(PSG)评估睡眠质量;采用福特应激睡眠反应量表(FIRST)、睡前觉醒状态量表(PSAS)、压力知觉量表(CPSS)和汉密尔顿抑郁(HAMD)、焦虑量表(HAMA)分别评估睡眠反应性、压力、觉醒和抑郁焦虑水平。结果表明:与对照组比较,CI组HAMD、HAMA、PSAS、FIRST和CPSS分显著增加(P<0.001),CI患者睡眠反应性和觉醒次数、N2期占比呈正相关,睡前觉醒、压力水平与睡眠潜伏期、觉醒次数呈正相关,焦虑分和睡眠潜伏期正相关,焦虑分和抑郁分都与睡眠效率呈负相关(P<0.05),ROC分析提示它们可能是区分CI患者和健康者较好的预测指标。CI组患者睡眠反应性、抑郁焦虑水平增高,且和CI组患者觉醒增加、睡眠效率降低关联。

To investigate the relationship between sleep reactivity,sleep awakening,stress,depression and anxiety levels and subjective and objective sleep quality in patients with chronic insomnia(CI),88 volunteers were recruited and divided into CI group(61 cases)and control group(27 cases).Pittsburgh Sleep Quality Index(PSQI)and polysomnography(PSG)were used to evaluate the sleep quality.The levels of sleep reactivity,stress,arousal,depression and anxiety were evaluated by Ford Stress Sleep Response Scale(FIRST),PSAS,Stress perception Scale and Hamilton Depression and Anxiety Scale(HAMD and HAMA),respectively.The results showed that compared with the control group,the scores of HAMD,HAMA,PSAS,FIRST and CPSS in CI group increased(P<0.001);sleep reactivity was positively correlated with the number of awakenings and N2 stage in CI patients;awakening before bedtime and stress level were positively correlated with sleep latency and wake up times.Anxiety scores were positively correlated with sleep latency,and anxiety scores and depression scores were negatively correlated with sleep efficiency(P<0.05).ROC analysis suggested that they may be good predictors to distinguish CI patients from healthy people.Sleep reactivity,depression and anxiety were increased in CI patients,and were associated with increased arousal and decreased sleep efficiency in CI patients.