门诊主诉失眠军人睡眠质量与睡眠节律及焦虑、抑郁的相关性研究

Correlation of sleep quality with sleep rhythm,anxiety and depression in armymen with insomnia

目的研究门诊主诉失眠军人睡眠质量与睡眠节律及焦虑、抑郁的相关性,寻找可能的失眠原因。方法以2014年1月—2015年4月门诊主诉失眠军人为研究对象,共纳入军人70例,男性25例、女性45例,年龄28~52(38±15.2)岁。以匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、清晨/夜晚型量表(morningness/eveningness questionnaire,MEQ)、汉密尔顿焦虑量表(Hanilton anxiety index,HAMA)和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)为评定量表,分析PSQI与其他量表的相关性。结果 1PSQI评分0~21(12.0±5.2)分,各因子得分分别为因子1主观睡眠质量(1.8±1.0)分、因子2睡眠潜伏期(2.1±1.0)分、因子3睡眠持续性(1.6±1.0)分、因子4习惯性睡眠效率(1.8±1.2)分、因子5睡眠紊乱(1.6±0.7)分、因子6使用睡眠药物(1.0±1.3)分、因子7白天功能紊乱(2.0±1.1)分。2MEQ评分44~76(61.3±7.6)分,其中绝对清晨型10例(14.3%)、中度清晨型25例(35.7%)、中间型32例(45.7%)、中度夜晚型3例(4.3%)、绝对夜晚型0例(0)。3HAMA评分5~42(17.7±9.0)分。4HAMD评分3~46(20.3±10.8)分。5经线性回归分析,发现MEQ与PSQI及其7项因子均不相关(P>0.05),HAMA、HAMD与PSQI及其7项因子均相关(P<0.05)。结论门诊主诉失眠军人的失眠情况与其本身的睡眠节律特征无关,而与焦虑、抑郁状态有明确的关系。对于门诊主诉失眠军人,除必要的安眠药物外,需要筛查焦虑、抑郁量表,结合量表情况予以适当的抗焦虑、抗抑郁治疗。

Objective To reveal the correlation of sleep quality with sleep rhythm,anxiety and depression in armymen with insomnia and to discover the main cause of insomnia of military outpatients. Methods Seventy cases of patients were enrolled,including 25 males and 45 females aged from 28 to 52 with an average of( 38 ± 15. 2). Correlations between Pittsburgh sleep quality index( PSQI),morningness/eveningness questionnaire( MEQ),Hamilton anxiety index( HAMA),Hamilton depression scale( HAMD) were studied in patients with insomnia from January 2014 to April 2015.Results PSQI score was 0 to 21 points with an average of( 12. 0±5. 2). Each factor score was as follows respectively: factor 1,subjective sleep quality( 1. 8±1. 0),factor 2,sleep latency( 2. 1±1. 0),factor 3,sleep duration( 1. 6±1. 0),factor 4,habitual sleep efficiency( 1. 8±1. 2),factor 5,sleep disorder( 1. 6±0. 7). factor 6,use sleep medicine( 1. 0±1. 3),factor 7,daytime dysfunction( 2. 0±1. 1). MEQ score was 44 — 76,with an average of( 61. 3±7. 6). The classification of MEQ was as follows,absolutely morningness type 10 cases( 14. 3%), moderately morningness type 25 cases( 35. 7%),intermediate type 32 cases( 45. 7%),moderately eveningness type 3 cases( 4. 3%),absolutely eveningness type 0 cases( 0). HAMA score was 5 — 42,with an average of( 17. 7 ± 9. 0).HAMD score was 3 — 46,with an average of( 20. 3±10. 8). By linear regression analysis,there was no relationship between the insomnia MEQ,PSQI and its 7 factors( P>0. 05). HAMA,HAMD PSQI and its 7 factors are related( P <0. 05). Conclusion Insomnia of military outpatients has nothing to do with sleep rhythm characteristics,but is definitely related to their anxiety and depression status. It’s important to do the anxiety and depression scale before prescription of sleeping pills. Antianxiety and antidepressant treatment might be necessary as an assistant therapy of insomnia.