失眠患者与健康人睡眠感知水平的对比分析失眠患者与健康人  

Comparative analysis of sleep state perception between insomniacs and good sleepers

作　　者：张鹏[1] 李雁鹏[1] 赵忠新[1] 黄流清[1] 庄建华[1] 吴惠涓[1] 常大川[1] 

机构地区：[1]第二军医大学附属长征医院神经内科,上海200003

出　　处：《中国现代神经疾病杂志》2008年第3期212-216,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：全军医学科学技术研究“十一五”计划保健专项课题(项目编号:07BJZ06);上海市科技发展基金资助项目(项目编号:024119029);第二军医大学附属长征医院“十一五”“三重三优”学科人才建设计划基金资助项目(项目编号:2005312)

摘　　要：目的研究失眠患者与健康人之间对睡眠状况主观感知和客观评估的差异,进一步探讨失眠患者主观睡眠感知的特点。方法通过睡眠日记晨间评估项目和多导睡眠图监测获取受试者的睡眠自我评估参数及客观睡眠参数。采用失眠严重程度指数、焦虑自评量表和抑郁自评量表等描述失眠程度并进行初步相关分析。结果与正常对照组相比,失眠组受试者的睡眠自我评估参数和多导睡眠图监测参数均显示睡眠潜伏期和觉醒时间延长,睡眠效率下降和总睡眠时间减少,组间差异有统计学意义(均P<0.01)。组内比较,两组受试者睡眠自我评估参数与多导睡眠图监测参数之间差异有统计学意义(均P<0.05),但失眠组这种差异较对照组更为显著(P<0.05),尤其是对睡眠潜伏期的评估误差。失眠组受试者睡眠自我评估误差呈现双向性。失眠组受试者焦虑自评量表评分和抑郁自评量表评分高于对照组(P<0.01),并与失眠严重程度指数呈正相关(P<0.01),焦虑自评量表评分与睡眠自我评估参数中的睡眠潜伏期呈正相关(P<0.01)。结论失眠患者睡眠质量下降,其对睡眠状态的自我评估误差显著高于健康受试者,且具有双向误差之特点,包括对睡眠状态的低估(夸大睡眠障碍)和对睡眠状态的高估(忽视夜间的睡眠缺失)。焦虑情绪可能与睡眠潜伏期感知误差具有直接相关性。Objective To analyse the discrepancy of sleep state perception as well as objective sleep measures between insomniacs and good sleepers, moreover, approach to the traits of sleep state perception in insomniacs. Methods Subjective measures of sleep state perception were obtained from a sleep diary （morning questionnaire） and objective measures from polysomnography （PSG）. Insomnia Severity Index （ISI）, Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS） were used to evaluate the severity of insomnia and preliminary related status. Results Both subjective parameters of sleep state perception and objective measures were significantly different between the insomniacs and controls （P〈 0.01, for all）. Prolonged sleep latency, increased wakefulness time after sleep onset, lower sleep efficiency and decreased total sleep duration were found in insomnia group. The difference of sleep state evaluation similarly, existed in both insomnia group and control group （P〈 0.05, for all）, but more prominent in insomniacs （P〈 0.05）, which overestimated their sleep latency particularly. The misperception from sleep state was bilateral in insomniacs. The scores of SAS as well as SDS in insomnia group exceeded control group （P〈 0.01）, and kept a positive correlation with ISI （P〈 0.01）. Especially, the scores of SAS correlated with subjective sleep latency （P〈 0.01）. Conclusion Insomniacs were poor in sleep quality. They had a similar misperception in sleep state compared with good sleepers, but more incongruity between subjective parameters and objective items. Sleep state misperception in insomniacs included bilateral aspect, underestimated their actual sleep state （exaggerat-ed their sleep disorder） or overestimated them （ignored nocturnal sleep deficien- cy）. With correlation test, anxiety as a factor, may directly relate to subjective sleep latency misperception.

关 键 词：失眠症 多道睡眠描记术 焦虑 病例对照研究 

分 类 号：R740[医药卫生—神经病学与精神病学]