某部2013年新兵睡眠质量及相关因素分析

目的了解某部2013年新兵的睡眠质量状况。方法采用自制的新兵心理卫生调查问卷及匹兹堡睡眠质量指数量表（PSQI）对某部200名2013年新兵进行调查测试。结果2013年新兵的睡眠质量异常检出率为17．01％,高于正常男性群体和2010年新兵（P=0．001）;2013年新兵的主观睡眠质量（SSQ）、入睡潜伏时间（sL）、睡眠干扰因素（Sdi）、应用催眠药物（USM）、白天功能障碍（DD）分值及PSQI总分均高于正常男性群体（P〈0．05,P〈0．01）;睡眠效率（HSE）低于正常男性群体（P〈0．05）,2013年新兵的SL、HSE、Sdi．及PSQI总分高于2010年新兵（P〈0．01）,睡眠时间（Sdu）分值低于2010年新兵（P〈0．05）。Logistic回归分析显示：非自愿入伍（P〈0．001,OR=8．782。95％CI=3．860～19．979）、认为不适应部队生活（P〈0．001,OR=6．731,95％CI=2．943—15．392）为2013年新兵睡眠质量异常的显著危险因子。结论2013年新兵的睡眠质量状况不容乐观,应当给予持续关注;乐观向上的心态有助于良好的睡眠质量。     

山东省18岁及其以上人群睡眠质量的现况调查

目的 调查山东省≥18岁人群睡眠质量现状和睡眠质量问题的发生率,探讨不同人群的睡眠质量特点.方法 采用多阶段分层整群系统随机抽样方法对全省≥18岁人群进行抽样,共抽取23 987人,实际完成问卷调查22 664人(94.48%).以匹兹堡睡眠质量指数(PSQI)总分＞7分为有睡眠质量问题.结果 (1)山东省≥18岁人群的平均睡眠时间为(7.9±1.4)h.PSQI评分为(3.42±3.57)分,其中农村[(3.46±3.61)分]高于城市[(3.30±3.43)分;经校正,t=3.03,P＜0.01];女性[(3.67±3.79)分]高于男性[(3.13±3.26)分,P＜0.01];随着年龄的增长PSQI评分上升,18～39岁人群[(2.25±2.61)分]低于40-59岁人群[(3.63±3.61)分]和≥60岁人群[(5.27±4.16)分;P＜0.01].(2)2973例(13.18%)有睡眠质量问题,其中女性有睡眠质量问题的发生率(15.57%,1902例)高于男性(10.36%,1071例;x2=132.96);随着年龄的增长睡眠质量问题发生率亦高,18～39岁者(5.20%,451例)低于40～59岁者(14.11%,1333例),亦低于≥60岁者(26.81%,1189例;x2=1 208.70);农村人群(13.69%,2316例)高于城市人群(11.66%,657例;x2=15.29);婚姻状况不良者和低文化程度人群(受教育年限0～6年)睡眠质量问题的发生率高,上述差异均有统计学意义(均P＜0.01).结论 山东省≥18岁人群的睡眠质量问题已成为明显的心理健康问题.     

慢性乙型肝炎患者睡眠质量与心理健康水平的相关研究

目的 了解慢性乙肝患者的睡眠质量和心理健康水平状况以及两者之间的关系,为改善慢性乙肝患者的睡眠质量和心理健康水平提供参考和依据.方法 随机抽取76例慢性乙肝患者采用匹兹堡睡眠质量指数量表（PSQI）和症状自评量表（SCL-90）进行问卷调查.结果 （1）53例（69.74％）慢性乙肝患者存在睡眠质量问题,睡眠质量不佳主要体现在日间功能障碍（75％）,入睡时间（68.42％）,睡眠质量（68.42％）,睡眠障碍（57.89％）.（2）26例34.21％的慢性乙肝患者存在心理问题,主要表现在强迫症状（14.47％）、抑郁（13.1％）、人际关系敏感（13.1％）、躯体化（13.1％）.（3）睡眠质量良和差的慢性乙肝患者在SCL-90总分及各因子得分上差异有统计学意义（P＜0.01）.（4）慢性乙肝患者PSQI总分及大多数因子分与SCL-90总分及各因子呈正相关（P＜0.05）.结论 慢性乙肝患者的睡眠质量与心理健康水平高度相关,因此要积极关注慢性乙肝患者的睡眠质量.     

Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome

Short sleep duration, poor sleep quality, and insomnia frequently characterize sleep in pregnancy during all three trimesters. We aimed: (i) to review the clinical evidence of the association between conditions of sleep loss during pregnancy and adverse pregnancy outcomes; and (ii) to discuss the potential pathophysiological mechanisms that may be involved. A systematic search of cross-sectional, longitudinal studies using Medline, Embase, and PsychINFO, and MeSH headings and key words for conditions of sleep loss such as ‘insomnia’, ‘poor sleep quality’, ‘short sleep duration’, and ‘pregnancy outcome’ was made for papers published between January 1, 1960 and July 2013. Twenty studies met inclusion criteria for sleep loss and pregnancy outcome: seven studies on prenatal depression, three on gestational diabetes, three on hypertension, pre-eclampsia/eclampsia, six on length of labor/type of delivery, eight on preterm birth, and three on birth grow/birth weight. Two main results emerged: (i) conditions of chronic sleep loss are related to adverse pregnancy outcomes; and (ii) chronic sleep loss yields a stress-related hypothalamic–pituitary–adrenal axis and abnormal immune/inflammatory, reaction, which, in turn, influences pregnancy outcome negatively. Chronic sleep loss frequently characterizes sleep throughout the course of pregnancy and may contribute to adverse pregnancy outcomes. Common pathophysiological mechanisms emerged as being related to stress system activation. We propose that in accordance to the allostatic load hypothesis, chronic sleep loss during pregnancy may also be regarded as both a result of stress and a physiological stressor per se, leading to stress ‘overload’. It may account for adverse pregnancy outcomes and somatic and mental disorders in pregnancy.     

多种精神障碍患者睡眠质量的调查

目的 研究精神障碍患者的睡眠特点和规律.方法 以河北省精神疾病流行病学现场抽样调查中符合美国精神障碍诊断与统计手册第4版诊断标准的13种精神障碍患者1874例(患者组)为研究样本.以调查中元任何精神障碍者15 117名为正常对照(对照组),采用匹兹堡睡眠质量指数中国修订版,评定两组最近1个月的睡眠质量,以>7分为有睡眠问题;采用功能大体评定量表评定社会生活功能.结果 (1)患者组有睡眠问题的发生率为48.61%(911例),高于正常人(5.55%,839例;P<0.01),其中以抑郁症者(69.92%)和广泛性焦虑障碍者(58.27%)为重.(2)患者组的睡眠质量问题表现为人睡时间长[(50±60)min]、总睡眠时间短[(7.1±4.3)h;P<0.01],对照组分别为(20±26)min和(8.4±2.4)h;抑郁症、心境恶劣障碍和广泛性焦虑障碍者早醒明显.(3)精神分裂症者[(1.0±1.4)分]和双相障碍者的[(0.7±1.3)分]催眠药物评分较高.(4)抑郁症[(1.8±1.2)分]和双相障碍[(1.6±1.3)分]患者日间功能最差.(5)患者组有睡眠问题者较无睡眠问题者的年龄偏大,教育水平低,功能损害更严重,女性多于男性,丧偶、农民、离退休、病退和家庭妇女有睡眠问题者较多.结论 精神障碍患者睡眠障碍发生率高,表现为人睡困难和总睡眠时间短,其中抑郁症患者最为明显;有睡眠问题受多种因素的影响.     

Subjective sleep quality and sleep problems in the general Japanese adult population.

To dimensionally describe subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and estimate the prevalence rate of sleep problems (PSQI global score > 5) in the general Japanese adult population, 1871 subjects randomly selected from the 1995 Census were examined. The PSQI component scores (mean +/- SD) widely ranged (e.g. 0.04 +/- 0.31 in hypnotic medication use for males aged 20-29 years, 0.03 +/- 0.18 in hypnotic medication use for females aged 20-29 years, 1.10 +/- 0.94 in sleep latency for males aged 80 or older, 1.52 +/- 1.03 in sleep latency for females aged 80 or older). Statistical significance was found in each component score among age groups by gender. The PSQI global scores (mean +/- SD) by age groups ranged from 4.00 +/- 2.59 to 5.02 +/- 3.89 for males (P < 0.39) and 4.30 +/- 2.34 to 6.75 +/- 4.10 for females (P < 0.001). The respective prevalence rates of sleep problems were 26.4% (95% CI = 23.6, 29.3) for males and 31.1% (95% CI = 28.1, 33.9) for females.     

Pregnancy Complications and Outcomes in a Cohort of Women with Epilepsy

To assess the possible adverse effects of maternal epilepsy on the course and outcome of pregnancy, all 138,780 Washington State birth certificates for the years 1980-81 were screened, and 204 births to epileptic mothers were identified. This was a lower than expected frequency of pregnancies in epileptic women. These births were compared with 612 randomly chosen control births for the same 2-year period. Of 46 pre- and perinatal events considered, eight were found to have occurred with significantly increased frequency for mothers with epilepsy. The offspring of these women were 2.8 times more likely to have low birth weight for their gestational age and 2.5 to 3.7 times more likely to have low Apgar scores or asphyxia. The excess risk of these adverse outcomes could not be explained by maternal race, parity, age, previous fetal loss, or socioeconomic status. These findings suggest that increased vigilance for complications of pregnancy and childbirth is warranted for epileptic women.     

Sleep and quality of life in the Austrian population

PURPOSE: To compare the self-reported estimation of sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) and life quality assessed by the Quality of Life Index (QLI). BACKGROUND: The PSQI comprised 19 questions and assessed a wide variety of factors relating to sleep quality. The QLI consisted of 10 items for self assessment of different dimensions of life quality. SUBJECTS: A representative Austrian sample (n = 1049) aged above 15 years. PROCEDURE: Interviews in the homes of the participants. RESULTS: 32.1% could be classified as poor sleepers (37% females, 26.5% males). Sleep quality decreased with increasing age, especially in women. Overall quality of life was highest in younger (15-29 years) and lowest in elderly subjects (over 50 years). Life quality decreased with increasing age. Between subjective sleep quality and quality of life a moderate, significant correlation was found (r2= 0.6721). CONCLUSIONS: Complaints about a bad quality of sleep could be used as a screening method in the exploration of patients' quality of life (QoL).     

卒中后抑郁患者匹兹堡睡眠量表与多道睡眠图研究

目的 探讨卒中后抑郁（PSD）患者的主观睡眠和客观睡眠情况,比较两种评估结果是否一致.方法 使用匹兹堡睡眠量表指数（PSQI）对PSD组和对照组患者的主观睡眠状况进行评估,并应用多道睡眠仪（PSG）对PSD组患者的客观睡眠状况进行记录,比较PSD组主客观睡眠的各项指标.结果 PSD组与对照组比较,PSQI各因子分及总分值偏高,差异有显著性;PSD组患者主观睡眠比客观睡眠障碍更加严重,差异有显著性.结论 PSD患者存在睡眠障碍,且PSD患者主观睡眠障碍比客观睡眠障碍更加严重.     

Factor structure of the Chinese version of the Pittsburgh Sleep Quality Index in breast cancer patients

ObjectiveThe Pittsburgh Sleep Quality Index (PSQI) is used extensively to assess subjective sleep disturbance in cancer populations. Although previous studies on the PSQI suggested a better fit for a two- or three-factor model than the original one-factor model, none accounted for the indicator-specific effect between sleep duration and habitual sleep efficiency. This study evaluated the PSQI’s dimensionality and its convergent validity with cancer-related psychopathological states in female breast cancer patients.MethodsThe PSQI was administered to 197 women with breast cancer. Confirmatory factor analysis examined the relative fit of one-, two-, three-, and revised one-factor models. The PSQI’s convergent validity was evaluated via bivariate correlations between the PSQI factor scores and measures of anxiety, depression, fatigue, pain, and quality of life.ResultsConfirmatory factor analyses showed an adequate fit for the revised one-factor model with the PSQI global score as the overall index of sleep disturbance. Although the revised one- and two-factor solutions showed statistically equivalent model fits, the one-factor model was selected due to utility reasons. The severity of sleep dysfunction that the PSQI global score represented was positively correlated with anxiety, depression, fatigue, pain, and reduced quality of life.ConclusionThe results support the PSQI’s original unidimensional structure, demonstrating that the PSQI global score is a valid and parsimonious measure for assessing and screening sleep dysfunction in cancer patients.     

Increases in duration of first uninterrupted sleep period are associated with improvements in PSQI-measured sleep quality

Objective

Urology clinical trials assessing bladder function have relied on the self-reported duration of the first uninterrupted sleep period (FUSP) as a proxy outcome for sleep, but the relationship between this measure and more conventional self-reported measures of sleep is unknown. In this study, we examined the association between changes in FUSP and a widely used self-reported measure of sleep, the Pittsburgh Sleep Quality Index (PSQI).

Methods

We conducted post hoc (secondary) analyses of unpublished data from a previously published randomized clinical trial (NCT00477490) of desmopressin (a medication used to treat nocturia) and examined relationships between baseline and 4-week change in FUSP and PSQI global and subscale scores for participants (N = 580 to N = 606) having complete data.

Results

Data indicated strong associations between change in PSQI global score and FUSP change in six of seven subscale scores. A reduction of 1.8 points in the PSQI global score was associated with a 72-min lengthening of FUSP.

Conclusions

Results suggest that FUSP is a potentially valuable metric that correlates with changes in perceived sleep duration, depth, quality for the entire night, efficiency, latency, and daytime function. An increase in FUSP was related to improvement in nearly all PSQI subscales. The validity of this measure in the general population remains to be determined.     

Benzodiazepine use and quality of sleep in the community-dwelling elderly population

Background: About 50% of the elderly population report being dissatisfied with their sleep. Although benzodiazepines are the most prescribed drugs to treat sleep complaints, the effectiveness of their use on the quality of sleep is not well documented.

Objectives: This study aimed to assess the association between benzodiazepine use and global sleep quality, as well as six components of sleep quality.

Methods: Data from the cross-sectional Quebec Survey on Seniors’ Health (n = 2798) conducted in 2005–2006 were used. Quality of sleep was self-reported and use of benzodiazepines was assessed during the previous year.

Results: Benzodiazepine users reported poorer quality of sleep than non-users. The association between benzodiazepine use and each of the six quality of sleep components studied were similar except for the daytime dysfunction component.

Conclusion: The results suggest that there is no evidence that using benzodiazepines is associated with better quality of sleep than non-users in the elderly population. Future longitudinal population-based studies are needed to assess improvements in quality of sleep in the elderly associated with the use of benzodiazepines.