多导睡眠仪的临床应用现况

多导睡眠仪作为一种监测睡眠的仪器,在临床逐渐上有着越来越广泛的应用。多导睡眠仪在睡眠障碍方面的应用使得睡眠障碍的监测预防、诊断评估和治疗评估更具量化性和直观性,达到辅助睡眠障碍的预防和诊治的目的。同时,睡眠障碍相关性疾病也得益于睡眠障碍的早期发现和临床干预,收到了一定的治疗效果。因此,降低了睡眠障碍及其相关性疾病的发病率,减缓了其疾病进程,降低了其严重程度并提高了其预后状况。目前,也有越来越多的临床疾病的研究和诊疗正在尝试应用多导睡眠仪。本文在复习相关文献的基础上,主要根据美国睡眠障碍联合会对睡眠障碍的分类概述目前多导睡眠监测仪在睡眠障碍以及其他相关临床疾病中的应用现况。     

帕金森病患者睡眠—觉醒障碍的临床表现及治疗进展

帕金森病是一种中老年人常见的神经系统变性疾病,帕金森病除了表现为运动症状外,非运动症状也是常见和重要的临床症状,睡眠障碍则尤为明显,其严重影响患者的生活质量,是导致患者丧失生活能力最常见的非运动症状。因此加强对睡眠障碍的认识、正确评估及合理治疗有非常重要的意义。本文对帕金森病睡眠-觉醒障碍发病率、病因及发病机制、常见临床表现、评估和治疗进行综述,以提高对帕金森病睡眠的关注,早诊断、早治疗,改善帕金森病患者的生活质量。     

便携式睡眠监测仪在阻塞性睡眠呼吸暂停综合征诊断中的应用

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种发病率较高、危害较大的常见慢性疾病。客观可靠地诊断OSAS并且准确评估病情严重程度,对该病的临床防治具有非常重要的意义。多导睡眠监测(polysomnography,PSG)是诊断和研究睡眠呼吸障碍     

慢性应激致睡眠障碍的研究进展

睡眠障碍是一种严重影响生活和工作的疾病,其常见原因之一为应激。急性应激障碍或创伤后应激障碍致睡眠异常的研究颇多,关于慢性应激致睡眠障碍的研究相对较少,并且,慢性应激致睡眠障碍一直深受临床医师关注。本研究主要通过对慢性应激致睡眠障碍的机制、危险因素、治疗等方面进行综述,旨在为临床慢性应激致睡眠障碍的诊治提供理论依据。     

脊髓损伤病人睡眠障碍影响因素的研究进展

对脊髓损伤病人睡眠障碍的常见类型、评估方法及其影响因素进行综述,旨在指导临床医护人员重视脊髓损伤病人睡眠障碍的评估和治疗,为制定相应干预策略提供依据。     

《体动记录仪评估睡眠障碍:美国睡眠医学会临床实践指南》要点解读

睡眠障碍是一个普遍存在的健康问题,体动记录仪是一种客观评估睡眠障碍的有效方法。近20年来,体动记录仪已被广泛用于评估睡眠/觉醒模式。2018年7月,美国睡眠医学会发布了《使用体动记录仪评估睡眠障碍》这一临床实践指南,旨在为临床中使用体动记录仪对睡眠障碍进行诊断提供临床指导。本文首先简述了睡眠常用的评估方法,继而重点介绍了体动记录仪在不同睡眠障碍评估中的应用,最后总结了体动记录仪的使用现况及主要注意事项。通过对指南要点进行解读,本文将为医务人员完善相关临床实践和开展相关科学研究提供参考。     

稳定期COPD患者的睡眠问题及护理干预

睡眠障碍在老年慢性阻塞性肺疾病（COPD）患者中十分常见,稳定期伴有睡眠障碍的患者往往生活能力和社会行为下降,以致影响生活质量。睡眠障碍对老年COPD患者健康状况的影响已引起临床的广泛关注和重视。本文从稳定期COPD患者睡眠障碍的相关因素、睡眠障碍对COPD患者生理和心理的影响、COPD患者睡眠障碍的护理干预等方面展开综述。     

老年患者睡眠障碍的原因分析及护理对策

睡眠障碍是临床上比较常见的一类疾病,是睡眠过程中表现出来的各种功能障碍,其定义范围比较广泛,包括失眠、过度嗜睡、睡眠呼吸障碍及睡眠行为异常等［1－2］。睡眠障碍在老年人群中发病率最高,近年来呈现上升趋势,严重的睡眠障碍会影响老年人的身体健康,甚至可能诱发一些疾病或加重现患病的病情,严重威胁老年患者的身心健康［3］。近年来,临床对老年人睡眠障碍进行了大量的研究,为治疗睡眠障碍提供了理论基础,如何针对性开展护理,以满足住院老年患者睡眠的要求、纠正老年患者的睡眠障碍、促进其身心康复、提高其生活质量,是护理工作者的重要职责。     

睡眠障碍对儿童学习记忆的影响及其机制研究进展

睡眠障碍是目前常见的一种可以引起心血管系统、神经系统疾病等的病理、生理过程。大量数据显示睡眠障碍问题越来越趋于年轻化,但目前对于儿童睡眠障碍问题的研究与成人相比较少。睡眠障碍会对儿童生长发育、学习记忆、免疫功能等产生不利影响,甚至可能增加远期抑郁症发生的风险。鉴于目前睡眠障碍问题越来越严重,且对学习记忆等认知功能的影响日益突出,全面了解常见的儿童睡眠障碍产生的原因和睡眠障碍对学习记忆的影响及其作用机制具有重要的临床意义,可为临床上儿童睡眠障碍治疗方式的选择提供新思路。     

阻塞性睡眠呼吸暂停低通气综合征患者血浆胰岛素和C肽水平的变化及临床意义

睡眠呼吸疾病是很常见的睡眠障碍,主要包括上气道阻力综合征、单纯鼾症、睡眠呼吸暂停低通气综合征和肥胖低通气综合征等.睡眠呼吸暂停低通气综合征又分为中枢性、阻塞性和混合性3型,临床上最常见阻塞性睡眠呼吸暂停低通气综合征(OSAHS).OSAHS是具有潜在危险性的疾病,可以累及全身各个器官,与多系统疾病密切相关,并在多种疾病中起到了源头作用[1].     

Options for Veterans Experiencing Sleep Impairment

This article provides an overview of methods to evaluate and manage sleep disorders in veterans, in particular, chronic insomnia. Treatment of sleep disorders may present a challenge for nurse practitioners (NPs) caring for veterans. Evidence-based guidance for pharmacotherapy, psychotherapy and some alternative and complementary modalities have shown efficacy in managing sleep disorders. It is suggested NPs consider utilize the Department of Veteran Affairs patient-centered care clinical practice protocols with consideration of a patient-centered approach when evaluating patients and determining modalities for treatment of sleep disorders.     

北京市古城社区卫生服务中心慢性病管理现况浅析

目的本研究依托北京大学首钢医院古城社区卫生服务中心的慢性病管理系统,对慢性病管理现状进行分析,以期为其他基层卫生服务机构及慢性病研究提供参考。 方法本研究通过分层随机抽样及当面随访相结合的方式调查目前北京市古城社区对可引起动脉粥样硬化的慢性病（高血压、糖尿病、高脂血症和睡眠障碍）的控制现状。 结果研究发现慢性病中,高血压患病率最高（88.22%）,并且用药较为合理,血压控制较为满意（53.61%）。高脂血症患病率为26.64%,用药较为规范合理,血脂控制满意（78.99%）。糖尿病患病率（39.19%）仅次于高血压,糖尿病用药相对较简单,随访中发现大部分糖尿病患者血糖控制欠佳（70.94%）。同时,社区慢病患者较为依赖中药制剂辅助治疗,这个问题需引起注意。此外,慢性病患者易合并睡眠障碍,常需口服镇静催眠药（36.49%）辅助睡眠,忽略了睡眠障碍实质是非躯体障碍,心理干预也许效果更好。 结论针对以上调查中发现的成就及暴露出的问题,采取相应措施,扬长补短,发挥首钢医院三级诊疗医联体的独特优势,助力“健康中国2030”。     

Dysfonction hémodynamique au cours du sepsis : approche expérimentale

Long-term noninvasive ventilation (NIV) is increasingly used in children. It requires the delivery of a ventilatory assistance by an interface that connects the patient??s airways, such as a nasal or facial mask, or rarely a nasal canula. NIV is indicated in diseases causing chronic alveolar hypoventilation, including neuromuscular disorders, maxillo-facial or upper airway abnormalities, thoracic deformities, some lung diseases, and disorders of respiratory control. In these diseases, NIV is the first-line treatment when chronic respiratory failure occurs because it is noninvasive and can be applied on demand, preferentially during sleep. The increasing use of NIV in children is explained by the improvement of the diagnosis of chronic alveolar hypoventilation, the availability of pediatric interfaces, and the increasing performance of home ventilators.     

渐进性放松术改善慢性肝病患者睡眠障碍的研究

目的观察护士引导下渐进性放松术改善慢性肝病患者睡眠障碍的效果。方法将120例有睡眠障碍的慢性肝病患者随机分为放松组（护士引导下渐进性放松训练）29例、薰衣草组（薰衣草温水擦浴及足浴）29例、联合组（综合使用以上两种方法）31例及对照组31例,观察并评价干预前、干预1周及2周后各组患者睡眠自评总分值、入睡困难及睡眠不稳分值的变化情况。结果护士引导下渐进性放松术能有效降低慢性肝病患者的SRSS自评总分,改善入睡困难和睡眠不稳（P＜0．05或P＜0．01）。结论护士引导下渐进性放松术是一种简便易行、快速有效的提高睡眠质量、改善睡眠障碍的护理方法。     

连续护理对改善社区慢性癌痛患者睡眠质量的研究

目的评价连续护理对改善社区慢性癌痛患者睡眠质量的效果。方法将74例慢性癌痛患者分为干预组和对照组。干预组进行3个月的疼痛管理社区连续护理,对照组给予常规疼痛护理。干预前后采用匹兹堡睡眠质量指数量表进行测量。结果癌痛患者匹兹堡睡眠质量指数量表总分为(14.78±3.17)分,存在睡眠障碍。干预后干预组在主观睡眠质量、睡眠潜伏期、睡眠持续性、睡眠紊乱、日间功能紊乱及匹兹堡睡眠质量指数量表总分较对照组有明显改善(P0.01或P0.05)。干预组自身前后对照结果显示,主观睡眠质量、睡眠潜伏期、睡眠紊乱、日间功能紊乱及匹兹堡睡眠质量指数量表总分均较干预前改善(P0.01或P0.05);对照组患者主观睡眠质量和睡眠紊乱两个因子较干预前恶化(P0.05)。结论对社区癌痛患者进行社区疼痛管理的连续护理可以改善睡眠质量。     

Noninvasive positive pressure ventilation for stable outpatients: CPAP and beyond

Noninvasive positive pressure ventilation (NIPPV) has been used in outpatients with sleep apnea, sleep disorders associated with heart failure, restrictive pulmonary diseases (subsuming neuromuscular diseases and thoracic cage deformities), severe stable chronic obstructive pulmonary disease, and the obesity-hypoventilation syndrome. NIPPV in these settings has resulted in significant physiologic benefits, improved quality of life, and in some cases longer survival. We discuss the modes of NIPPV, current indications, and potential benefits.     

Sleep rhythm and cardiovascular diseases

Sleep disturbance is a common problem in general adult population. Recent evidence suggests the link between the occurrence of cardiovascular events and several sleep disturbances including sleep apnea syndrome, insomnia and periodic limb movements during sleep. Sleep duration may affect the cardiovascular outcome. Shift work also may increase the risk of ischemic heart disease. Normalization of sleep rhythm has a potential to be a therapeutic target of ischemic heart diseases, although further study is required to evaluate the preventive effect on cardiovascular events. Here we describe the current understandings regarding the roles of sleep disorders during the pathogenesis of cardiovascular events.     

Headache in patients with chronic obstructive pulmonary disease: effects of chronic hypoxaemia

The frequency and characteristics of headache in patients with chronic obstructive pulmonary disease (COPD) are not clear and there are only a few studies that have assessed the relationship between chronic hypoxaemia and headache. We performed this study in order to evaluate the frequency and characteristics of headache in COPD patients. A total of 119 patients, with a mean age of 63.4 ± 8.2 years, diagnosed with moderate or severe stable COPD were included in the study. Overall 31.9% of the patients complained of headache and 45.4% were reported to have sleep disorders. There were significant effects of family history of COPD, having other systemic disorders or sleep disorders (snoring, bruxism, restless leg syndrome, etc.) and laboratory data of chronic hypoxaemia and airway obstruction on headache co–morbidity. In conclusion, possibly being a specific subtype of elderly headache, headache in patients with moderate or severe COPD is a common problem and future studies are needed to obtain more knowledge about its pathophysiological and clinical basis.     

Music therapy improves sleep quality in acute and chronic sleep disorders: A meta-analysis of 10 randomized studies

Objective

To evaluate the efficacy of music therapy for acute and chronic sleep disorders in adults.

Design

Systematic review and meta-analysis.

Data sources

A systematic search of publications in PubMed, Embase, and the Cochrane Library without language restriction was performed.

Review methods

Studies with randomized controlled design and adult participants were included if music was applied in a passive way to improve sleep quality. Subgroup analysis was conducted to explore the sources of heterogeneity.

Results

Ten studies involving 557 participants were identified. The sleep quality was improved significantly by music (standard mean difference: −0.63; 95% CI: −0.92 to −0.34; p < 0.001), with significant heterogeneity across studies. Subgroup analysis found heterogeneity between subgroups with objective or subjective assessing methods of sleep quality, and between subgroups with difference follow-up durations. No evidence of publication bias was observed.

Conclusion

Music can assist in improving sleep quality of patients with acute and chronic sleep disorders. For chronic sleep disorders, music showed a cumulative dose effect and a follow-up duration more than three weeks is necessary for assessing its efficacy.