Sleep quality in middle-aged and elderly hemodialysis patients:Impact of a structured nursing intervention program

BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.

Relationship between sleep quality and blood pressure level in nurses performing shift work

Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)and quality of sleep.Methods:A total of 20 nurses of the therapeutic depar tments and 20 nurses of the surgical depar tments were enrolled in the study.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI).BP was measured according to the standard protocol using the Korotkoff method;a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m.and 10:30 a.m.The average value for the 2 indicators was calculated.The diagnosis of essential ar terial hyper tension(AH)was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension(2018).Results:The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality;this was true in respondents of both the surgical and therapeutic profiles.However,it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments.Moreover,poor sleep quality was associated with AH,which was diagnosed in 65%of the nurses of the therapeutic departments and 45%of the nurses of the surgical departments,that is,in almost all of the subjects.Herewith,in the nurses of the therapeutic departments,the level of systolic BP exceeded that of the nurses of the surgical departments.Conclusions:Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work.Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.

Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery

BACKGROUND Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevoflurane has become an issue for preventing sleep disturbance.AIM To compare sleep quality on the first postoperative night for female patients after total intravenous anesthesia by propofol and total inhalation anesthesia with sevoflurane.METHODS We enrolled 61 American Society of Anesthesia(ASA) class Ⅰ-Ⅱ outpatients who underwent minor gynecologic surgeries by either propofol or sevoflurane anesthesia. Sleep quality of the very night was assessed by the Pittsburgh Sleep Quality Index(PSQI) on the next day, and PSQI scores were compared by the Wilcoxon signed-rank test and paired t-test pre-operatively and postoperatively.RESULTS For the propofol group, the mean postoperative global PSQI score(3.3 ± 1.3) was lower than the mean preoperative global PSQI score(4.9 ± 2.3)(P < 0.001);for the sevoflurane group, the mean postoperative global PSQI score(6.5 ± 2.8) was higher than the mean preoperative global PSQI score(5.5 ± 3.2)(P = 0.02). Eighty percent of patients receiving propofol anesthesia subjectively reported improved sleep quality, but only 17% of patients receiving sevoflurane anesthesia reported improved sleep quality.CONCLUSION Sleep quality assessed by the PSQI is better improved in ASA class Ⅰ-Ⅱ female patients receiving propofol anesthesia other than sevoflurane anesthesia for undergoing minor gynecologic surgeries.

Sleep quality in elderly patients with obstructive sleep apnea syndrome

AIM:To investigate the sleep quality in elderly patients with obstructive sleep apnea syndrome (OSAS). METHODS:54 cases of elderly patients with OSAS were evaluated by the pittsburgh sleep quality index (PSQI) questionnaire. RESULTS:Among 54 OSAS patients, 35 cases (65%) reported poor quality of sleep, only 7(13%) cases reported good. A significant negative correlation was found between apnea/hypopnea index (AHI) and PSQI, and part of its components. CONCLUSION:Elderly patients with OSAS often complain of poor quality of sleep. Daytime dysfunction, poor subjective sleep quality, low habitual sleep efficiency and long sleep latency constitutes the principal parts of the symptoms about sleep.

Can subjective sleep quality, evaluated at the age of 73, have an influence on successful aging? The PROOF study

Objective: Sleep complaints are recurrent in Geriatrics and are often attributed to physiological aging. The aim of this work is to describe subjective sleep quality and its impact on successful aging. Methods: Subjective sleep quality was evaluated by using the Pittsburgh subjective sleep quality questionnaire. Two visual analogical scales (graduate from 0 to 10) were used to quantify perceived state of health and life satisfaction. Objective respiratory sleep parameters were also collected. Results: 370 data were analysed (46.2% of males). The average age was 73.2 +/- 1. The level of perceived state of health was 6.9 +/- 2, and life satisfaction level was 7.7 +/-2. Subjective sleep quality was significantly related to perceived health status (p = 0.034) and life satisfaction (p = 0.005). There was no significant association between sleep quality and objective respiratory sleep parameters. Conclusion: The assessment of sleep quality plays an important role in the management of elderly persons and can help them to age more successfully.

Relationship between depression,smartphone addiction,and sleep among Chinese engineering students during the COVID-19 pandemic

BACKGROUND Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic.AIM To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates.METHODS Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version(SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep.RESULTS Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01;95% confidence interval(CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022(P < 0.01;95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040(P < 0.01;95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively.CONCLUSION The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.

Relationship of Lifestyle Habits with Sleep Quality among Japanese in Their 20s

The purpose of this study was to analyze the effects of lifestyle on sleep quality in young Japanese adults. A cross-sectional study was conducted on the web. We analyzed 637 eligible subjects (316 men and 321 women) aged 20 - 29 years. Information on diet and individual lifestyle characteristics, including sleep quality, which was assessed using the Pittsburgh Sleep Quality Index Japanese version (PSQI-J). Results were obtained by participants completing an online questionnaire. The participants were divided into two groups based on whether they were students (“student group”) or not (“not student group”). The participants with a PSQI-J global score of 6 or higher were evaluated as low-sleep-quality. Logistic regression analyses were performed to evaluate associations of lifestyle habits with low-sleep-quality. Logistic regression analyses were applied for “student group” and “not student group”. The results showed that days of eating out at dinner (OR: 1.11, CI: 1.00 - 1.22) and skipping dinner (OR: 1.21, CI: 1.05 - 1.42) were significant and independent predictors for low-sleep-quality among the “not student group”. There were no significant and independent predictors for low-sleep-quality among “student group”. Our results suggested that excessive intake by eating out and deficient intake by skipping dinner might lead to a high PSQI-J score. It is necessary for young people to receive education on the importance of cooking their own meals for traditional and daytime eating. The implication of this study lies in the fact that we have analyzed the effects of lifestyle habits on quality of sleep.

Effect of Eating out on Quality and Quantity of Sleep among Japanese in Their 20s

The purpose of this study was to analyze the effects of eating out or skipping meals on the quality or quantity of sleep in young Japanese adults. We analyzed 584 eligible subjects (283 men and 301 women) aged 20 - 29 years. Information on diet and individual lifestyle characteristics, including sleep quality, which was assessed by the Pittsburgh Sleep Quality Index Japanese version (PSQI-J), were obtained by participants completing an online questionnaire. Kendall’s tau coefficient was used to measure the ordinal association between diet and sleep quality. The Mann-Whitney U test was performed to evaluate differences in sleep quality by frequency of eating out and frequency of skipping meals. The results revealed a significant difference in sleep duration and PSQI-J score between people who eat out >2 times a week (“high restaurants group”) and those who do not (“low restaurants group”). Furthermore, whereas the mean sleep duration in the “high restaurants group” was 6.59 hours, the mean sleep duration in the “low restaurants group” was 6.90 hours (p = 0.007). The PSQI-J score was significantly higher in the “high restaurants group” than in the “low restaurants group” (4.91 versus 4.37, p = 0.006). Significant differences were also evident in the test’s component scores: C2, C3, and C7. No significant difference was found in sleep duration and PSQI-J score between the groups in terms of frequency of skipping meals (breakfast, lunch, and dinner). Our results suggested that excessive intake by eating out more than twice a week may lead to short sleep duration and high PSQI-J score.

Relationship of depression and sleep quality,diseases and general characteristics

BACKGROUND Depression is the most common type of depressive disorder.The most common sleep disorder associated with depression is insomnia.Insomnia and depression are closely related.AIM To investigate the relationship of designed questionnaire items and depression,and analyze the related factors with depression.METHODS Questionnaire included Patient Health Questionnaire-9(PHQ-9)and Pittsburgh sleep quality index(PSQI),12 kinds of diseases,8 general characteristics,and 20 insomnia characteristics,totally 56 items were filled out by 411 patients enrolled.RESULTS All the 9 items of PHQ-9,6 components of PSQI(except sleep duration),education,living situation,exercise,years of insomnia,western medicine treatment,Chinese medicine treatment,psychotherapy,kinds of insomnia,treatment expected to treat insomnia,psychological counseling,habit of 1 h before bed,habit of lunch break,diagnosed depression,coronary heart disease,mental illness showed significant difference between without and with depression group.By univariate analysis and multivariate analysis.The odds ratio of education,exercise,kinds of insomnia,habit of 1 h before bed,diagnosed depression,coronary heart disease(P=0.01)showed significant difference.Their odds ratios were 0.71(0.55,0.93),2.09(1.32,3.31),0.76(0.63,0.91),0.89(0.81,0.98),0.32(0.17,0.60),0.43(0.23,0.79).CONCLUSION We demonstrated that education,exercise,kinds of insomnia,habit of 1 h before bed,diagnosed depression and coronary heart disease affect the depression.

等离子扁桃体包膜内切除术对睡眠呼吸暂停综合征患者PSQI、VAS评分的影响

目的:观察等离子扁桃体包膜内切除术对睡眠呼吸暂停综合征患者匹兹堡睡眠质量指数(PSQI)、视觉模拟评分法(VAS)评分的影响。方法:选取2022年2月至2023年4月福建省仙游县总医院收治的睡眠呼吸暂停综合征患者88例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组44例。对照组实施常规手术方案治疗,观察组实施按照等离子扁桃体包膜内切除术治疗。评估患者术后PSQI、VAS评分等改善情况。结果:术前,2组患者PSQI评分比较,差异无统计学意义(P>0.05),术后观察组评分低于对照组,差异有统计学意义(P<0.05)。术前,2组患者VAS评分比较,差异无统计学意义(P>0.05),术后,观察组评分低于对照组,差异有统计学意义(P<0.05)。术前,2组患者呼吸功能改善情况比较,差异无统计学意义(P>0.05),术后,观察组呼吸功能高于对照组,差异有统计学意义(P<0.05)。结论:在对睡眠呼吸暂停综合征患者治疗时,应用等离子扁桃体包膜内切除术治疗,可以提升患者睡眠质量,降低其疼痛程度,有助于其恢复。

Sleep Quality in Non Dialysis Chronic Kidney Disease: Associated Factors and Influence on Prognosis

Deficient sleep quality (SQ) has been linked with a higher hospitalization rate and mortality in dialysis patients, however the prevalence of sleep disorders and their influence on prognosis in non-dialysis chronic kidney disease (CKD) has been poorly investigated. The aim of this study was to assess factors related with SQ in CKD patients (stages I-IV) followed in a nephrology outpatient clinic as well as the long-term impact of SQ on patient’s outcome. Between January and May 2008, Pittsburgh Sleep Quality Index (PSQI) was self-administered by 122 patients (68 males and 54 females) with a mean age of 65 years. Patients were classified as “good” (global PSQI < 6) and “poor” sleepers (global PSQI ≥ 6). We identified 66 (54%) poor sleepers (PS), characterized by an older age (66 ± 14.2 vs 57 ± 17.0, p < 0.01), female predominance (59% vs 26%, p < 0.01) and worse renal function (49 ± 19.1 vs 57 ± 23.2 ml/min, p < 0.05). There was a significant correlation between phosphate and PSQI score (r = 0.234, p = 0.01), however no correlation with calcium or PTH. Vitamin D was also lower in PS (17 ± 7.2 vs 23 ± 15.1 ng/ml, p < 0.05). Until June 2015, hospitalization rate was higher among PS (64% vs 44%, p < 0.05). In this period, there was also a trend towards higher mortality for PS (18% vs 16%). In summary, over 50% of CKD patients have poor SQ, which was associated with older age, female gender, worse renal function, lower vitamin D and higher phosphate levels. Deficient sleep was associated with a greater probability of hospitalization and might be a prognostic marker in CKD.

Survey of the Sleep Quality of Medical Staff in a Grade A Tertiary Hospital during the Novel Coronavirus Pneumonia Outbreak

This study aimed to investigate the sleep quality of medical staff in China who are combatting novel coronavirus pneumonia(COVID-19).To perform this,a survey of 127 medical staff from three separate wards(the general ward,isolation ward,and fever clinic)of a Grade A tertiary hospital in China was conducted.The survey questionnaire measured general characteristics and included the Pittsburgh Sleep Quality Index(PSQI).We consequently found that global PSQI scores differed significantly between the different wards(χ2=44.561,P<0.001).Whilst the medical staff in the general ward did not report any sleep disturbances,those in the isolation ward and the fever clinic both exhibited various degrees of sleep disturbance(global PSQI score>7).Medical staff in the isolation ward had the worst sleep quality(mean rank=91.74),followed by those in the fever clinic(mean rank=70.52)and the general ward(mean rank=39.10),respectively.The primary sleep disturbances reported by the medical staff from the isolation ward included difficulty falling asleep(24 cases,71.42%),waking early or at night(28 cases,80%),and nightmares(18 cases,51.42%).In addition,31.42%(11 cases)of the medical staff from the isolation ward had less than six hours of sleep a night,and 65.71%(23 cases)felt that their sleep quality was poor;meanwhile,for the staff from the fever clinic these ratios were 16.67%(seven cases)and 33.33%(14 cases),respectively.In contrast,among medical staff in the general ward,98%(49 cases)reported sleeping for more than six hours a night,and 96%felt that their sleep quality was good.In conclusion,of the medical staff providing treatment for COVID-19,those in isolation wards and fever clinics are more likely to experience sleep disturbances.

Effect of Mindfulness-based Cognitive Training on Sleep Quality and Mindfulness Cognitive Level of College Students

Objective:To study the effect of mindfulness-based cognitive training on sleep quality and mindfulness cognitive level of college students who score below the critical value of sleep disorders.Methods:The subjects were freshmen of a university in Shanghai who had scored below the critical value of sleep disorders.They were divided into the control group and experimental group by a random number table method,with 35 students in each group.No intervention was provided in the control group,and the mindfulness-based cognitive training(1 hour per day,5 days per week for 8 consecutive weeks)was performed in the intervention group.Eight weeks later,the Pittsburgh Sleep Quality Index(PSQI)and Five Facet Mindfulness Questionnaire(FFMQ)scores were compared between the two groups before and after the intervention for changes in the sleep quality and mindfulness cognitive level.Results:The sleep quality and daytime dysfunction were significantly improved,the sleep latency was shortened,the sleep duration was prolonged(P<0.05),and the mindfulness level of the subjects was significantly improved(P<0.05)in the intervention group compared with the control group.Conclusion:Mindfulness-based cognitive training can significantly improve the sleep quality of college students who scored below the critical value of sleep disorders.Furthermore,its psychological mechanism may be associated with the improvement of the mindfulness level of college students.

中医穴位贴敷联合耳穴压豆在妊娠期失眠患者护理中对PSQI评分及睡眠时长的影响

目的 探究分析中医穴位贴敷联合耳穴压豆在妊娠期失眠患者护理中对PSQI评分及睡眠时长的影响。方法 选取2020年1月-2022年10月在医院接受治疗的68例妊娠期失眠患者作为研究对象,随机分为对照组和观察组,对照组使用常规失眠护理方法,保证孕妇各项生命指标的稳定,观察组使用中医穴位贴敷联合耳穴压豆优质护理方法。干预后比较两组匹兹堡睡眠质量指数(PSQI)评分,疲劳乏力、心悸、浅睡易醒、入睡困难中医证候积分,心理状态,入睡时间和睡眠时长。结果 (1)观察组匹兹堡睡眠质量指数(PSQI)评分低于对照组;(2)观察组疲劳乏力、心悸、浅睡易醒、入睡困难中医证候积分低于对照组;(3)观察组SAS焦虑评分、SDS抑郁评分低于对照组;(4)观察组入睡时间短于对照组,睡眠持续时间长于对照组,差异均有统计学意义(P<0.05)。结论 中医穴位贴敷联合耳穴压豆优质护理可以改善妊娠期失眠患者疲劳乏力、心悸、浅睡易醒、入睡困难等中医证候积分,通过简单安全的中医护理操作方法降低妊娠对身体产生的影响,使用情志护理纾解妊娠期失眠患者担忧、抑郁、紧张等不良心理状态,降低她们的匹兹堡睡眠质量指数评分,延长睡眠持续时间,使其睡眠质量得到显著的提升。

输尿管结石患者排石颗粒联合钬激光碎石术治疗PSQI评分及BUN水平的变化

目的:探讨排石颗粒联合钬激光碎石术在输尿管结石疾病治疗中的应用价值。方法:选取2022年4月至2023年4月泉州滨海医院收治的输尿管结石患者110例作为研究对象,按照随机数字表法分为对照组和观察组,每组55例。对照组选择钬激光碎石术,观察组选择排石颗粒联合钬激光碎石术治疗。比较2组临床疗效、炎症介质水平、肾功能、睡眠质量。结果:观察组临床疗效显著高于对照组,差异有统计学意义(P<0.05)。治疗前,2组炎症介质水平、肾功能指标、睡眠质量比较,差异均无统计学意义(均P>0.05);治疗后,与对照组比较,观察组炎症介质水平、肾功能水平升高幅度较低,睡眠质量评分较低,差异均有统计学意义(均P<0.05)。结论:排石颗粒联合钬激光碎石术治疗输尿管结石患者,临床效果显著,可以减轻炎症反应,改善肾功能,强化睡眠质量。

“零转介”AIDS诊疗管理模式的临床验证

目的探讨“零转介”诊疗管理模式对人类免疫缺陷病毒(HIV)感染患者治疗疗效和满意度的效果。方法选取石家庄市第五医院2022年7月至12月新增HIV感染者100例,随机分为对照组和研究组,每组50例。对照组给予常规认知干预和健康指导、心理干预,研究组在确诊前较对照组提前7~10 d即给予认知干预、生活指导和心理干预。比较对照组和研究组患者的HIV感染患者睡眠[匹兹堡睡眠质量指数表(PSQI)]、服药依从性、焦虑抑郁量表分值。结果对照组患者的PSQⅠ评分高于研究组患者(P<0.01);研究组患者的焦虑抑郁的心理状况要优于对照组(P<0.05);对照组患者服药依从性良好者比例低于研究组患者(P<0.01);研究组患者对疾病的接受度和认知评定量表均好于对照组患者(P<0.01)。结论“零转介”模式,提前给予认知干预、生活指导和心理干预,可提高HIV感染患者满意度,对社会层面的AIDS预防具有积极意义。

声刺激联合认知行为治疗慢性耳鸣的初步探讨

目的 探讨声刺激联合认知行为治疗(CBT)对慢性耳鸣的临床疗效。方法 本研究将49例慢性耳鸣患者按照随机数字表法分为干预组(25例)和对照组(24例),所有患者均行声音刺激1个月。干预组患者同时接受持续1个月的个体化的CBT,对照组患者不接受个体化CBT。所有患者在治疗前和治疗后30 d均需填写问卷,包括耳鸣残疾评估量表(THI)、焦虑自评量表(SAS)及匹兹堡睡眠质量指数(PSQI)。结果 两组患者均完成临床试验。治疗1个月后观察,对照组患者THI、SAS、PSQI的平均值分别下降15.58、15.46、4.96,干预组患者THI、SAS、PSQI的平均值分别下降40.52、41.76、7.72,差异具有统计学意义(P<0.05);且干预组患者THI、SAS、PSQI的得分均明显低于对照组。结论 声音刺激和CBT可以预测治疗效果,声音刺激联合CBT的治疗效果优于单独的声音刺激。性别、年龄和听力障碍是耳鸣最相关的危险因素。

多导睡眠监测仪在精神分裂症患者中的应用及其对睡眠质量和结构的监测效果研究

目的:探究与分析多导睡眠监测仪在精神分裂症患者中的应用及其对睡眠质量和结构的监测效果。方法:选取2021年3月至2023年5月新疆医科大学第一附属医院收治的90例精神分裂症患者作为观察组,同时选择80名健康志愿者作为健康对照组,所有受试者均采用多导睡眠监测仪进行睡眠监测,对比两组匹兹堡睡眠质量指数(PSQI)评分、多导睡眠监测仪睡眠质量指标、睡眠结构指标、纺锤波指标;同时Pearson相关性分析探讨PSQI评分与睡眠参数的相关性。结果:健康对照组PSQI评分为(5.36±0.65)分,观察组PSQI评分为(14.24±3.58)分,观察组PSQI评分高于健康对照组,差异有统计学意义(t=23.115,P<0.05)。观察组与健康对照组相比,睡眠总时间较短、睡眠潜伏期较长、快速动眼期(REM)较短以及觉醒次数较多,差异均有统计学意义(t=15.136、40.355、36.620、24.226,P<0.05)。观察组治疗前与健康对照组的REM潜伏期比较,差异无统计学意义(P>0.05)。观察组治疗后与观察组治疗前相比睡眠总时间较长、睡眠潜伏期较短、REM期较长、觉醒次数较少,差异均有统计学意义(t=3.145、12.021、8.668、9.101,P<0.05),观察组治疗后与健康对照组相比睡眠总时间较短、睡眠潜伏期较长、REM期较短、觉醒次数较多,差异均有统计学意义(t=9.704、14.781、15.899、9.901,P<0.05)。健康对照组与观察组治疗前相比,N1%值较高、N2%值较高及N3%值较低,差异有统计学意义(t=10.163、9.483、10.065,P<0.05)。健康对照组与观察组治疗前、治疗后的REM%比较,差异均无统计学意义(P>0.05)。观察组治疗后与治疗前相比N1%值较低、N2%值较低、N3%值较高(t=10.163、9.483、10.065,P<0.05),治疗后与健康对照组相比N1%值较高、N2%值较高、N3%值较低,差异均有统计学意义(t=7.628、4.210、7.153,P<0.05)。观察组治疗后与治疗前相比纺锤波密度、振幅和时间均较高,观察组治疗后与健康对照组相比,纺锤波密度较低、振幅较低、时间较短,差异有统计学意义(t=2.514、2.665、2.014,P<0.05)。Pearson相关性分析显示,PSQI评分分别与睡眠总时间、REM期、N3%、纺锤波密度及纺锤波振幅呈现出了明显的负相关性,与睡眠潜伏期、觉醒次数、N1%、N2%呈现了明显的正相关性(r=-0.612、-0.269、-0.812、-0.778、-0.841;r=0.382、0.226、0.654、0.778,P<0.05)。结论:实施多导睡眠监测仪监测可观察到精神分裂症患者存在睡眠质量及结构异常的表现,且睡眠纺锤波的活性也呈现出了异常的表现,其指标与PSQI之间具有密切的关系。

“调督安神”针刺联合四逆散治疗老年顽固性失眠患者的临床观察

目的观察“调督安神”针刺联合四逆散治疗老年顽固性失眠患者的疗效,为其治疗提供方法。方法纳入2021年6月—2023年6月在遂宁市第三人民医院治疗的中医辨证为心脾两虚证的老年顽固性失眠患者102例,采用随机数字表法分为对照组和观察组,每组51例。对照组口服右佐匹克隆片,观察组在与对照组相同治疗的基础上加用“调督安神”针刺联合四逆散治疗,2组患者均持续治疗2周。比较2组临床疗效、中医证候评分和匹兹堡睡眠质量指数量表(PSQI)评分。结果观察组治疗有效率高于对照组(94.12%vs 78.43%,P<0.05)。治疗1周后,观察组患者神疲乏力、多梦易醒、头晕目眩、心悸易惊及注意力不集中评分均低于同组治疗前(P<0.05),而对照组上述各项评分与治疗前差异均无统计学意义(P>0.05);治疗2周后,两组的神疲乏力、多梦易醒、头晕目眩、心悸易惊及注意力不集中评分均低于同组治疗前,且观察组上述评分低于对照组(均P<0.05)。治疗1周后,观察组患者PSQI评分明显低于同组治疗前和对照组(均P<0.05);治疗2周后,观察组和对照组患者PSQI评分明显低于同组治疗前,且观察组PSQI评分低于对照组(均P<0.05)。结论西药右佐匹克隆片联合“调督安神”针刺与四逆散加味方治疗老年顽固性失眠患者,疗效确切,可显著改善患者的临床症状,具有一定的应用价值。