识别绝经女性阻塞性睡眠呼吸暂停患者心理与睡眠问题网络的核心症状  

Identify the core symptoms of the network of psychological and sleep problems in menopausal women with obstructive sleep apnea

作　　者：钟清清 莫金芳 施令丽 梁安康 梁碧芳[1] 唐彬鋆 苏月靓 张敏[1] 杨元欢 谭海龙 黄含 赵明明 ZHONG Qingqing;MO Jinfang;SHI Lingli;LIANG Ankang;LIANG Bifang;TANG Binyun;SU Yueliang;ZHANG Min;YANG Yuanhuan;TAN Hailong;HUANG Han;ZHAO Mingming(Department of Sleep Medicine,Guangxi Research Center for Sleep Medicine in Clinical Sciences,the People's Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院(广西医学科学院)睡眠医学科,广西睡眠医学临床医学研究中心,530021

出　　处：《中国神经免疫学和神经病学杂志》2024年第6期453-458,471,共7页Chinese Journal of Neuroimmunology and Neurology

基　　金：国家自然科学基金项目(82260021);广西自然科学基金项目(2022GXNSFBA035655);广西医疗卫生适宜技术开发与推广应用项目(S2021046);广西重点研发计划(AB24010061,AB24010065);广西科技重大专项(AA23023004)。

摘　　要：目的构建绝经女性阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者心理与睡眠问题的症状网络,识别核心症状。方法纳入2022年至2023年广西壮族自治区人民医院睡眠医学科收治的117例绝经女性OSA患者,年龄(63.94±7.81)岁。采用症状自评量表(symptom check list-90,SCL-90)和匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)分别评估患者的心理和睡眠情况,根据SCL-90和PSQI各项因子评分是否≥2分分为各因子阳性症状组和阴性症状组。采用网络分析法构建心理与睡眠症状网络,通过中心性指标,识别核心症状,分析桥梁强度,比较桥梁症状阳性组和阴性组心理和睡眠特点。结果绝经女性OSA患者最常见的心理症状是躯体化(47.01%)、强迫(43.59%)和焦虑(31.62%),常见的睡眠问题是入睡时间长(75.21%)、睡眠质量差(74.36%)、睡眠时长短(73.50%)。中心性最高的心理症状和睡眠问题分别为焦虑(strength=1.291)和睡眠质量差(strength=1.816),“睡眠障碍”因子(bridge strength=0.242)是该网络的桥梁症状。“睡眠障碍”因子阳性组的患者SCL-90量表评分显著高于“睡眠障碍”因子阴性组(P<0.01),且N3期占总睡眠时间百分比少(P=0.020)。结论焦虑和睡眠质量差是绝经女性OSA患者心理与睡眠症状网络的核心症状,为该人群的临床诊断提供新思路,为临床治疗确定关键干预靶点,以及减轻绝经女性OSA患者的症状管理负担提供理论依据。Objective To construct the symptom network of psychological and sleep problems in menopausal women with obstructive sleep apnea(OSA),and identify the core symptoms.Methods A total of 117 menopausal female OSA patients,average age(63.94±7.81)years,admitted to the Sleep Medicine Department of the People's Hospital of Guangxi Zhuang Autonomous Region from 2022 to 2023 were included.Symptom check list-90(SCL-90)and Pittsburgh sleep quality index(PSQI)were used to evaluate the psychological and sleep status of the patients.According to whether SCL-90 and PSQI scores was equal or more than 2,they were divided into positive symptom group and negative symptom group.The psychological and sleep symptom network was constructed by network analysis.The core symptoms were identified by the central index,the bridge strength was calculated,and the psychological and sleep characteristics of the positive and negative bridge symptom groups were compared.Results The common psychological symptoms among menopausal women with OSA were somatization(47.01%),obsessive-compulsive tendencies(43.59%),and anxiety(31.62%).The most frequent sleep issues were prolonged sleep onset(75.21%),poor sleep quality(74.36%),and short sleep duration(73.50%).The psychological symptom and sleep problem with the highest centrality were anxiety(strength=1.291)and poor sleep quality(strength=1.816),respectively.Sleep disorder factor(bridge strength=0.242)served as the bridge symptom in this network.The SCL-90 score of patients in thesleep disorder factor positive group was significantly higher than that in thesleep disorder factor negative group(P<0.01),and the percentage of N3 in total sleep time was less than that in thesleep disorder factor negative group(P=0.020).Conclusions Anxiety and poor sleep quality are core symptoms in the psychological and sleep symptom network of menopausal women with OSA,providing new insights for the clinical diagnosis and key intervention targets of this population.It offers a theoretical basis for alleviating the symptom mana

关 键 词：绝经女性 阻塞性睡眠呼吸暂停 网络分析 核心症状 

分 类 号：R766[医药卫生—耳鼻咽喉科] R749.72[医药卫生—临床医学]