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1.
失眠症患者的多导睡眠图研究   总被引:25,自引:2,他引:23  
目的 探讨失眠症患者多导睡眠图睡眠参数的变化特征。方法 对62例单纯性失眠症患者和22名正常人进行多导睡眠图描记,并进行各睡眠参数比较。结果 与正常人比较,失眠症患者睡眠潜伏期长(21.7分),觉醒次数多(5.4次),实际睡眠时间少(330.6),睡眠效率低(73.3%)。睡眠结构快眼动(REM)时间减少(17.1%),REM活动度和密度低,自我估价与实际睡眠时间不一致(52.9%;P〈0.05 ̄  相似文献
2.
The purpose of this study is to explore the direction of the association between insomnia and anxiety disorders and major depression among a community-based sample of adolescents to better understand their potential etiologic relationships. Data come from a community-based sample of 1014 youth aged 13–16. Structured interviews were conducted to assess DSM-IV diagnoses. Retrospectively reported ages of onset were used in Proportional Hazards models to estimate increased risk of one disorder associated with prior onset of the others. The lifetime associations of DSM-IV insomnia with each anxiety disorder and with depression were moderate (OR = 3.2–6.8). Among those with comorbid disorders, anxiety disorders preceded insomnia 73% of the time, while insomnia occurred first in 69% of comorbid insomnia and depression cases. Any prior anxiety disorder was associated with an increased risk of insomnia adjusting for gender, race/ethnicity, and depression prior to insomnia (HR = 3.5). However, prior insomnia was not significantly associated with onset of anxiety disorders. Prior depression was not associated with onset of insomnia, but prior insomnia was associated with onset of depression adjusting for gender, race/ethnicity, and any prior anxiety disorder (HR = 3.8). These results suggest distinct natural courses of development between DSM-IV insomnia, anxiety, and depression during adolescence. Additionally insomnia may have independent, and potentially etiologically distinct, directional associations with anxiety disorders versus depression.  相似文献
3.
OBJECTIVE: Psychometric evaluation of the Pittsburgh Sleep Quality Index (PSQI) for primary insomnia. METHODS: The study sample consisted of 80 patients with primary insomnia (DSM-IV). The length of the test-retest interval was either 2 days or several weeks. Validity analyses were calculated for PSQI data and data from sleep diaries, as well as polysomnography. To evaluate the specificity of the PSQI, insomnia patients were compared with a control group of 45 healthy subjects. RESULTS: In primary insomnia patients, the overall PSQI global score correlation coefficient for test-retest reliability was .87. Validity analyses showed high correlations between PSQI and sleep log data and lower correlations with polysomnography data. A PSQI global score > 5 resulted in a sensitivity of 98.7 and specificity of 84.4 as a marker for sleep disturbances in insomnia patients versus controls. CONCLUSION: The PSQI has a high test-retest reliability and a good validity for patients with primary insomnia.  相似文献
4.
What are the contributing factors for insomnia in the general population?   总被引:11,自引:0,他引:11  
Lack of a systematic assessment of insomnia has led to large variations in its reported prevalence in the general population. This study aims to provide new guidelines to assess insomnia prevalence. A cross-sectional telephone survey using the Sleep-EVAL system was done with 24,600 general population-based subjects 15 years and older representative of general populations (France, the UK, Germany, Italy, Portugal, and Spain) consisting of 251,405,391 inhabitants. The overall participation rate was 81.0%. Within the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) symptomatology for insomnia, 27.2% (95% confidence interval: 26.6–27.8%) of the sample reported difficulty initiating sleep (DIS) (10.1%) or maintaining sleep (DMS) (disrupted sleep (DS): 18.0%; early morning awakening (EMA): 10.9%) or nonrestorative sleep (NRS) (8.9%) at least three times per week; 48.5% of them were concomitantly suffering of a DSM-IV sleep/mental disorder. A factor analysis identified several variables strongly related to each of the major factors of insomnia allowing: (1) The narrowing of the definition of insomnia: the prevalence of insomnia decreased to 16.8% with 64.5% of insomnia subjects having a DSM-IV sleep/mental disorder; (2) The identification of a sleep-deprived (voluntary or not) group without insomnia symptoms, representing 2.1% (1.9–2.3%) of the sample. Interestingly, the latter group closely matched the definition of insufficient sleep syndrome as described by the International Classification of Sleep Disorders (ICSD). Using more delineated criteria to assess insomnia increases the recognition of subjects complaining about sleep. Classifications should be amended to improve the correct identification of insomnia. Sleep-deprived subjects should also not be neglected.  相似文献
5.
失眠症相关因素的调查   总被引:11,自引:0,他引:11  
目的探讨失眠症病人的人格特性、负性情绪等相关因素.方法采用自制失眠一般情况调查(其中包括影响睡眠相关因素调查表)、匹兹堡睡眠质量指数量表(PSQI)、EPQ、焦虑自评量表(SAS)、抑郁自评量表(SDS)对106例门诊失眠症病人进行调查,与90例健康对照组进行比较.结果①失眠组的E分低于正常组,N分、L分高于正常组(P<0.01);②失眠组SAS、SDS评分高于正常对照组;③E分与N、SAS、SDS评分呈负相关,N分与SAS、SDS评分呈正相关,P分与SAS、SDS评分呈正相关,SAS与SDS评分呈正相关(P<0.01);④对影响睡眠质量相关因素进行多元逐步回归分析得出焦虑、病程、经济状况、轮班制进入回归方程.结论失眠患者的人格具有内倾性和不稳定性,其负性情绪与人格特征有关,失眠可受病程、经济状况、轮班制、负性情绪的影响.  相似文献
6.
内因性失眠症患者中枢抑制源GABA震荡的脑电涨落变化   总被引:11,自引:1,他引:10  
目的:观察30例失眠人群,中枢神经系统γ-氨基丁酸(GABA)及谷氨酸(Glu)测定值变化,探讨GABA及Glu在内因性失眠人群发病中的作用机制,为临床防治提供依据。方法:采用脑电超慢涨落技术对30例内因性失眠患者及30名对照组分别检测中枢神经递质分布变化。结果:观察对象中16例中枢神经递质分布图提示S1GABA明显降低(P值为0·0031),Glu明显升高(P值为0·0016)。结论:通过脑电超慢涨落分析,发现内因性失眠症患者中枢重要的抑制性神经递质GABA显著降低及Glu明显升高,导致睡眠觉醒周期自主调节紊乱。  相似文献
7.
Gender differences in insomnia--a study in the Hong Kong Chinese population   总被引:10,自引:0,他引:10  
OBJECTIVE: To study the epidemiology of insomnia in the adult Chinese population in Hong Kong and to examine the potential gender-related demographic and lifestyle factors in insomnia. METHODS: A population study via random telephone survey with a structured questionnaire was carried out for noninstitutionalized Chinese adults aged 18-65 by trained lay interviewers. The questionnaire included demographic data, sleep habits and problems, insomnia symptoms and lifestyle questions. RESULTS: A total of 9851 subjects (46.4% male; 53.6% female) were included in the final analysis. The overall prevalence of Hong Kong Chinese as suffering from insomnia during the preceding month (with a frequency of sleep disturbance of at least three times per week) was 11.9% (95% CI 11.2-12.6), including difficulty in initiating sleep (DIS) (4.5%; 95% CI 4.1-5.0), difficulty in maintaining sleep (DMS) (6.9%; 95% CI 6.4-7.5) and early morning awakening (EMA) (4.0%; 95% CI 3.6-4.4). Females were about 1.6 times at higher risk for insomnia than males. The prevalence of insomnia was also shown to increase with age. Multivariate analysis showed that unemployment, lower economic status, alcohol consumption, regular medication and psychiatric disturbance were all associated with higher risks of insomnia in both sexes. Furthermore, lower education level and being retired was associated with a higher risk of insomnia in males, but being a housewife, divorced/widowed, and complaining of a nocturnal noisy environment were associated with a higher risk of insomnia in females. Among all these factors, psychiatric disturbance was the most influential risk factor for insomnia in both sexes. The reasons for gender differences of insomnia may include their differences in the prevalence of psychiatric morbidities, symptom endorsement, gonadal steroids, sociocultural factors and coping strategies. CONCLUSIONS: Overall, 11.9% of the Hong Kong Chinese adult population complained of frequent insomnia in the preceding month. There was a higher prevalence of insomnia in females. Although there were common risk factors for insomnia in both sexes, there existed gender-specific risk factors.  相似文献
8.
Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria   总被引:9,自引:0,他引:9  
OBJECTIVES: To describe and validate the Athens Insomnia Scale (AIS). METHODS: The AIS is a self-assessment psychometric instrument designed for quantifying sleep difficulty based on the ICD-10 criteria. It consists of eight items: the first five pertain to sleep induction, awakenings during the night, final awakening, total sleep duration, and sleep quality; while the last three refer to well-being, functioning capacity, and sleepiness during the day. Either the entire eight-item scale (AIS-8) or the brief five-item version (AIS-5), which contains only the first five items, can be utilized. The validation of the AIS was based on its administration to 299 subjects: 105 primary insomniacs, 144 psychiatric patients and 50 non-patient controls. RESULTS: Regarding internal consistency, for both versions of the scale, the Cronbach's alpha was around 0. 90 and the mean item-total correlation coefficient was about 0.70. Moreover, in the factor analysis, the scale emerged as a sole component. The test-retest reliability correlation coefficient was found almost 0.90 at a 1-week interval. As far as external validity is concerned, the correlations of the AIS-8 and AIS-5 with the Sleep Problems Scale were 0.90 and 0.85, respectively. CONCLUSION: The high measures of consistency, reliability, and validity of the AIS make it an invaluable tool in sleep research and clinical practice.  相似文献
9.
The diagnostic validity of the Athens Insomnia Scale   总被引:9,自引:0,他引:9  
OBJECTIVE: To provide documentation for the diagnostic validity of the Athens Insomnia Scale (AIS), a self-assessment psychometric tool which has previously shown high consistency, reliability and external validity for the evaluation of the intensity of sleep difficulty. METHODS: The AIS was administered to a total of 299 subjects (105 primary insomniacs, 100 psychiatric outpatients, 44 psychiatric inpatients and 50 nonpatient controls) who were also assessed for the ICD-10 diagnosis of "nonorganic insomnia" blindly in terms of the AIS scores. RESULTS: 176 subjects were identified as insomniacs and 123 as noninsomniacs. Logistic regression of AIS total score against the ICD-10 diagnosis of insomnia demonstrated that a score of 6 is the optimum cutoff based on the balance between sensitivity and specificity. When diagnosing individuals with a score of 6 or higher as insomniacs, the scale presents with 93% sensitivity and 85% specificity (90% overall correct case identification). For this cutoff score, in the general population, the scale has a positive predictive value (PPV) of 41% and a negative predictive value (NPV) of 99%. For the same cutoff score, among unselected psychiatric patients, the PPV was found to be 86% and the NPV 92%. Other cutoff scores can be also considered, however, depending on the importance of avoiding false positive or false negative results; for example, for a cutoff score of 10, the PPV in the general population reaches about 90% without the NPV becoming lower than 94%. CONCLUSION: The AIS can be utilized in clinical practice and research, not only as an instrument to measure the intensity of sleep-related problems, but also as a screening tool in reliably establishing the diagnosis of insomnia.  相似文献
10.
OBJECTIVE: The purpose of this study was to examine whether there is a bidirectional relationship between, on one hand, anxiety and depression and, on the other hand, insomnia over the course of a year. METHODS: A randomly selected sample of 3000 participants from the general population filled out a baseline survey (N=1812) and a 1-year follow-up survey (N=1498) on anxiety, depression, and insomnia. RESULTS: On cross-sectional analyses, bivariate correlations showed that anxiety, depression, and insomnia were significantly intercorrelated (varphi=.31-.54). On prospective analyses, logistic regression analyses demonstrated that anxiety at baseline [odds ratio (OR)=4.27 (8% of variance)] and depression at baseline [OR=2.28 (2% of variance)] were related to new cases of insomnia on follow-up. Furthermore, insomnia at baseline was related to new episodes of high anxiety and high depression on follow-up [OR=2.30 (2% of variance) and OR=3.51 (4% of variance), respectively]. CONCLUSION: Evidence suggests that there is a bidirectional relationship between, on one hand, anxiety and depression and, on the other hand, insomnia. This suggests that anxiety, depression, and insomnia are intertwined over time, implying implications for theoretical conceptualizations and interventions.  相似文献
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