失眠症患者睡眠质量的主观评估与多导睡眠图参数对比分析  

Comparative analysis of subjective estimation and polysomnography of sleep quality in patients with insomnia

作　　者：孙阳[1] 杨志杰[1] 古雅兰[2] 沈扬[3] 樊东升[3] 吕旌乔[4] 

机构地区：[1]北京大学第三医院神经科睡眠中心,清华大学第一附属医院神经科100083 [2]北京大学第三医院耳鼻喉科,100083 [3]清华大学第一附属医院神经科 [4]北京大学第三医院临床流行病学研究中心,100083

出　　处：《中华神经科杂志》2007年第3期195-198,共4页Chinese Journal of Neurology

摘　　要：目的探讨失眠症患者对睡眠质量的主观评估,并通过对多导睡眠图(PSG)睡眠参数的定量分析,对失眠症患者的睡眠状况进行客观评估,进一步将二者进行对比分析。方法对失眠症患者和健康人各100例运用匹兹堡睡眠质量指数问卷(PSQI)进行评定,并分别进行多导睡眠图的整夜睡眠描记,次日晨起后询问夜问睡眠情况。结果失眠症组 PSQI 各成分得分及总分均高于对照组,差异有统计学意义(P<0.01)。与对照组相比,失眠症组的睡眠潜伏期(min)延长(失眠症组43.69±11.54,对照组16.01±10.44)、总睡眠时间(min)减少(失眠症组314.65±91.89,对照组446.41±77.81)、睡眠效率降低(失眠症组64.51%±18.59%,对照组91.32%±3.58%)、快眼动睡眠时间(min)减少(失眠症组33.26±15.61,对照组93.21±21.63),差异有统计学意义(P<0.01)。失眠症组对总睡眠时间的评估较 PSG 检测值显著减低、对睡眠潜伏期的评估较 PSG 检测值显著增高,自我评估与实际睡眠情况不一致。结论失眠症患者睡眠质量较差。失眠症患者的 PSG 各睡眠参数有特征性的改变,利用 PSG 检查发现失眠症患者对失眠情况的主客观评估不一致,存在过高估价睡眠潜伏期和过低估价睡眠时间的倾向。Objective To study the subjective estimation on sleep quality of the patients with insomnia followed by objective observation on their sleep quality using polysomnography and to compare the subjective estimate of sleep with objective polysomnographic data. Methods 100 patients of insomnia and 100 normal controls were measured with Pittsburgh Sleep Quality Index （PSQI） and underwent all-night polysomnography. The sleep latency, total sleep time and sleep efficiency were rated after getting up the next morning. Results There were significant differences of sleep quality between the patients with insomnia and the normal controls. A prolonged sleep latency （ patients with insomnia 43.69 ± 11.54, normal controls 16. 01 ± 10. 44）, decreased total sleep duration （patients with insomnia 314. 65 ± 91.89, normal controls 446. 41 ± 77.81 ）, low sleep efficiency （ patients with insomnia 64. 51% ± 18.59%, normal controls 91.32% ± 3.58% ）, abnormal sleep architecture such as decreased REM sleep（patients with insomnia 33.26 ± 15.61, normal controls 93.21 ± 21.63 ） were found in patients with insomnia. The difference between subjective sleep and objective estimates of sleep was significant. Conclusions The insomnia patients have lower sleep quality and varying features of PSG parameters. There are differences between subjective and objective estimates of sleep in the insomniacs. The insomniacs tend to overestimate the sleep latency and underestimate the sleep time. Observation and quantitative analysis of polysomnograms might distinguish subjective insomnia from objective insomnia.

关 键 词：入睡和睡眠障碍 睡眠质量 多道睡眠描记术 失眠症 多导睡眠图 

分 类 号：R740[医药卫生—神经病学与精神病学]