慢性主观性头晕患者睡眠质量、疲劳严重度及日间嗜睡情况调查  

Sleep quality,fatigue and daytime sleepiness in chronic subjective dizziness

作　　者：陈健华[1] 黄颜[1] 刘秀琴[1] 孙鹤阳[1] 孟琼[1] 

机构地区：[1]中国医学科学院北京协和医院神经内科,北京100730

出　　处：《临床荟萃》2011年第17期1486-1490,1493,F0002,共7页Clinical Focus

摘　　要：目的对无前庭功能障碍的慢性头晕既慢性主观性头晕（CSD）患者睡眠质量、疲劳严重度、日间嗜睡以及焦虑抑郁情况进行调查。方法被调查者181例,其中CSD患者103例和对照者78例。所有参加者均完成了匹茨堡睡眠量表（PSQI）、疲劳严重度量表（FSS）、爱泼沃斯嗜睡量表（ESS）、抑郁自评量表（SDS）、焦虑自评量表（SAS）测评。同时进行了汉密尔顿抑郁量表（HAMD）及焦虑量表（HAMA）测定。采用非参数检验及χ2检验进行统计分析。运用Spearman相关分析和逻辑回归法对CSD与PSQI、ESS、FSS以及焦虑抑郁之间的关系进行研究。结果 CSD患者睡眠障碍、疲劳、日间过度嗜睡的患病率分别为90.3%（93/103）、70.9%（73/103）和46.6%（48/103）。46.6%~48.5%的CSD患者存在焦虑,51.5%~55.3%存在抑郁。CSD患者与对照组相比,睡眠质量、疲劳严重度、日间嗜睡及焦虑抑郁发生率明显高于对照组（均P〈0.05或〈0.01）。逻辑回归分析显示焦虑抑郁（P〈0.01,OR=35.732,95%CI=7.690~166.023）、睡眠质量（P〈0.01,OR=7.053,95%CI=2.675~18.595）和疲劳严重度（P〈0.05,OR=2.910,95%CI=1.186~7.140）与CSD之间有显著相关性。结论焦虑抑郁、睡眠质量差、疲劳与CSD相关。CSD患者睡眠质量下降,疲劳严重,存在日间过度嗜睡,焦虑抑郁情况突出。Objective Chronic dizziness without identifiable vestibular impairments is described as chronic subjective dizziness（CSD）.The objective of this study was to evaluate sleep quality,fatigue,daytime sleepiness and psychiatric comorbidity in CSD.Methods We investigated 181 subjects including 103 CSD patients and 78 controls.All participants completed the Pittsburgh Sleep Quality Index（PSQI）,the Fatigue Severity Scale（FSS）,the Epworth Sleepiness Scale（ESS）,the Zung Self-rating Depression Scale（SDS）,the Zung Self-rating Anxiety Scale（SAS）.The Hamilton Depression Rating Scale（HAMD） and the Hamilton Anxiety Rating Scale（HAMA） were fulfilled.For statistical analysis,we used nonparametric test and χ2 test.To see the correlations between CSD and PSQI,ESS,FSS,as well as psychiatric state,the Spearman correlation and logistic regression were used.Results The frequencies of poor sleep,fatigue and daytime sleepiness in CSD were 90.3%,70.9% and 46.6%,respectively.Overall,46.6%-48.5% of the patients suffered from anxiety,51.5%-55.3% depression.The patients differed from the controls statistically regarding sleep quality,fatigue,daytime sleepiness,anxiety and depression.Logistic regression demonstrated that psychiatric disorder（P〈0.01,OR=35.732,95%CI=7.690-166.023）,sleep quality（P〈0.01,OR=7.053,95%CI=2.675-18.595） and fatigue（P〈0.05,OR=2.910,95%CI=1.186-7.140） were associated with CSD.Conclusion Psychiatric disorder,sleep quality and fatigue are associated with CSD.The quality of sleep in patients with CSD is decreased.Fatigue,daytime sleepiness and psychiatric disorders are more prominent in the patients.

关 键 词：头晕 睡眠 疲劳 焦虑 抑郁 

分 类 号：R746.9[医药卫生—神经病学与精神病学]