某高校学生睡眠状况调查及失眠的防治

目的了解在校大学生睡眠状况,探讨大学生失眠的治疗和预防方法,以便更好地防止失眠的发生,有效地医治失眠患者。方法采用睡眠自测AIS量表,用填表调查的方法,随机抽样调查大学一年级~四年级学生756人。结果在756人中,可能有睡眠问题的人有287人(37.9%),失眠人数为136人(17.9%)。女生失眠人数83人(21.1%),男生失眠53人(14.5%),差异有统计学意义(χ2=9.436,P<0.01),女生失眠发生率明显高于男生。结论在大学生群体中,睡眠障碍发生率较高,应引起高度关注,应加强科学睡眠的健康教育,预防睡眠障碍的发生。     

社区卫生中心门诊老年男性患者失眠现状及与认知功能关系的研究

目的：调查于社区卫生服务中心就诊的老年男性患者失眠现状、认知功能损害特点及其相关影响因素。方法：入选我社区2021年3月～2021年6月门诊就诊老年男性患者，按DSM-5诊断标准分为持续性失眠组、发作性失眠组和睡眠正常组，比较不同组患者睡眠质量和认知功能。结果：共纳入332例男性老年患者，平均年龄（67.39±9.53）岁，三组之间一般资料无统计学意义P>0.05。共诊断失眠患者97例（29.22%），其中持续性失眠组60例（18.07%）、发作性失眠组37例（11.15%）。持续性失眠组PSQI总分及各因子分（日间功能障碍除外）均高于正常组P<0.05；发作性失眠组的PSQI总分及多数因子分（睡眠紊乱、催眠药物和日间功能障碍除外）高于正常组P<0.05；持续性失眠组PSQI总分、睡眠质量及催眠药物因子分高于发作性失眠组P<0.05。持续性失眠组的Mo CA总分、语言、抽象思维、延迟回忆及定向力均低于正常组P<0.05，发作性失眠组的Mo CA总分、延迟回忆及定向力低于睡眠正常组P<0.05，持续性失眠组的语言功能低于发作性失眠组P<0.05。...     

甘肃省成年人失眠状况调查与因素分析及对策*

目的了解甘肃省成年人失眠症患病情况及原因。方法运用分层整群随机抽样方法抽取甘肃省公务员、医务人员和高中生1 7261人,采用一般情况问卷、汉密顿抑郁量表、汉密顿焦虑量表、症状自评量表和匹兹堡睡眠质量指数量表进行调查。结果共有15 687人完成调查,其中轻度睡眠障碍1 793人,占11.4%;中度睡眠障碍1 030人,占6.6%;重度睡眠障碍674人,占4.3%。结论甘肃省失眠症患病率在国内处于中间水平,失眠人数较多,需要积极治疗。     

失眠了来一片镇静催眠药？

睡眠问题是广泛困扰大众的问题之一。为了解决失眠的困扰,很多人愿意选择镇静催眠药缓解失眠。专家在此特别提醒大家请勿乱用镇静催眠药,因为合理服用镇静催眠药对健康有利,有助于帮助失眠患者改善睡眠,避免失眠对人体健康的损害及保证生活质量,但应用不当也可影响健康。大多数镇静催眠药并不属于精神药品,但会对中枢神经系统有广泛的抑制作用。     

不觅仙方觅睡方,天天都有精气神

据世界卫生组织(WHO)对14个国家15个地区的25916名在基层医疗机构就诊的病人进行调查,发现有27%的人有睡眠问题。据报道,在美国,失眠发生率为32%～50%,英国为10%～14%,日本为20%,法国为30%。在我国,失眠发生率在30%以上,50%的学生存在睡眠不足。其中女性发病人数是男性的1.5倍,3/4是40～60岁的中老年人。失眠危害极大,但是相当多的失眠患者却没有得到合理的诊断和治疗。为唤起世人对睡眠重要性的认     

临沂市农村学龄儿童睡眠问题及相关因素研究

【目的】探讨临沂市农村学龄儿童睡眠问题的发生率及相关因素。【方法】对2004名农村学龄儿童进行调查。父母完成有关儿童睡眠问题、家庭及儿童特征的问卷,教师完成包括修订Conner多动指数、是否在课堂上睡觉及学习成绩的问卷。【结果】父母报告的睡眠问题"有时"或"经常"发生者为:说梦话或梦游占14.2%;睡眠过少占14.0%;睡眠过多占12.5%;梦魇占12.0%;睡眠不好占6.1%;夜间遗尿占4.5%。教师报告9.4%的儿童"有时"或"经常"在课堂上睡觉。约11%的儿童"经常"有任何睡眠问题。具有睡眠问题的儿童常报告有多动,亲子关系差,与同学关系差,社会能力及学习成绩差。多变量Logistic回归分析揭示,睡眠问题与父母关系差、家庭住房拥挤、4岁后停止尿床、慢性躯体疾病、报告有多动及与同学关系差等因素显著相关。【结论】临沂市农村学龄儿童睡眠问题的发生与家庭、母孕期及儿童生长发育等多种因素有关。有睡眠问题的儿童常有多动,社会及学业问题。     

431例医务人员营养状况及睡眠情况调查分析

目的 调查医务人员的营养状况和睡眠情况,为改善医务人员的健康状况提供参考。方法 采用问卷调查法,对医务人员营养状况、饮食规律、睡眠质量及失眠情况进行调查。结果 共调查431名医务人员,其中有3人(0.70%)中度营养不良,24人(5.57%)轻度营养不良,无重度营养不良者;营养状况正常共286人(66.36%),超重共82人(19.02%),肥胖共36人(8.35%)。被调查者的匹兹堡睡眠质量指数量表(PSQI)总分为(6.52±2.18)分,不同年龄、职位、日均工作时长、每周值夜班次数的医务人员间营养状况及PSQI评分比较,差异均有统计学意义(P<0.05)。431名医务人员中,经常按时吃三餐的129人(29.93%),有时无法按时三餐的有215人(49.88%),偶尔能够按时三餐的87人(20.19%);存在失眠情况的有94人(21.81%),不同年龄、日均工作时长、每周值夜班次数的医务人员间,失眠程度差异均有统计学意义(P<0.05)。结论 医务人员的不良营养状况以超重为主,多数医务人员难以保持规律饮食,部分医务人员因夜班影响存在睡眠障碍。     

医界快讯

调查显示中国成年人失眠率38.2%,高于发达国家据世界卫生组织调查,27%的人有睡眠问题。中国睡眠研究会公布的最新睡眠调查结果显示,中国成年人失眠发生率更是高达38.2%,高于国外发达国家的失眠发生率。医学研究表明,偶尔失眠会造成第二天疲倦和动作不协调,长期失眠则会带来注意力不集中、记忆出现障碍和工作力不从心等后果。     

心内科老年住院患者失眠原因调查及护理探讨

目的调查了解心内科老年住院病人的睡眠状况及原因,探讨有效改善失眠状况的护理措施。方法采用睡眠状况自评量表及科室自行设计的调查表收集病人睡眠状况相关资料并根据失眠的原因采取有针对性的护理措施,护理干预后再次进行睡眠状况评估。结果心内科老年病人失眠的发生原因中,22.5%由于环境改变(噪音、光线等),33%由于疾病本身的因素引起,心理因素也占了17.5%,其他原因仅占2%。经过护理干预,各类型失眠的发生率均显著降低,差异有统计学意义(P﹤0.05)。结论采取综合护理措施可以有效减低心内科老年住院病人失眠的发生率。     

耳穴埋豆对恶性肿瘤失眠患者影响研究

目的研究耳穴埋豆对恶性肿瘤失眠患者生活质量和睡眠改善效果。方法以首都医科大学附属北京中医医院住院治疗的恶性肿瘤失眠患者为研究对象,随机分成观察组和对照组,对照组行常规护理干预,研究组在对照组基础上联合耳穴埋豆护理2周,对比2组干预前后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和匹兹堡睡眠质量指数量表(PSQI)得分情况,并分析2组患者睡眠质量改善情况。结果本研究纳入148例恶性肿瘤失眠患者,观察组和对照组各74例,对照组男性38例(占51.35%),女性36例(占48.65%),平均(59.14±9.23)岁。观察组男性42例(占56.76%),女性32例(占43.24%),平均(59.28±9.41)岁。2组患者的性别分布、平均年龄差异均无统计学意义(均P0.05)。观察组和对照组HAMD、HAMA总分均明显低于干预前(均P0.01),且观察组干预后HAMD、HAMA、PSQI各方面评分及总分均低于干预后的对照组得分(均P0.01)。干预后观察组患者睡眠质量改善有效率为94.59%(70/74),高于对照组的78.38%(58/74),差异有统计学意义(P0.05)。结论对恶性肿瘤失眠患者行耳穴埋豆护理干预,可有效改善患者心理状态、睡眠质量,进一步提高临床治疗效果,建议推广使用。     

Patients' and clinicians' experiences and perceptions of the primary care management of insomnia: qualitative study

Background

Insomnia is common leading to patients with sleep problems often presenting to primary care services including general practice, community pharmacies and community mental health teams. Little is known about how health professionals in primary care respond to patients with insomnia.

Aim

We aimed to explore health professionals'' and patients'' experiences and perceptions of the management of insomnia in primary care.

Design

We used a qualitative design and thematic approach.

Setting

Primary care in Nottinghamshire and Lincolnshire.

Method

We undertook focus groups and one‐to‐one interviews with a purposive sample of health professionals and adults with insomnia.

Results

We interviewed 28 patients and 23 health professionals. Practitioners focused on treating the cause of insomnia rather than the insomnia itself. They described providing stepped care for insomnia, but this focused on sleep hygiene which patients often disregarded, rather than cognitive behavioural therapy for insomnia (CBT‐I). Practitioners were ambivalent towards hypnotic drugs but often colluded with patients to prescribe to avoid confrontation or express empathy. Patients sometimes took hypnotics in ways that were not intended, for example together with over‐the‐counter medication. Practitioners and patients were sometimes but not always concerned about addiction. Practitioners sometimes prescribed despite these concerns but at other times withdrew hypnotics abruptly without treating insomnia. Both patients and practitioners wanted more options and better training for the management of insomnia in primary care.

Conclusion

A better understanding of the current approaches and difficulties in the management of insomnia will help to inform more therapeutic options and health professional training.     

An assessment of quality of sleep and the use of drugs with sedating properties in hospitalized adult patients

Background  

Hospitalization can significantly disrupt sleeping patterns. In consideration of the previous reports of insomnia and apparent widespread use of benzodiazepines and other hypnotics in hospitalized patients, we conducted a study to assess quality of sleep and hypnotic drug use in our acute care adult patient population. The primary objectives of this study were to assess sleep disturbance and its determinants including the use of drugs with sedating properties.     

Occupational risk of infection by varicella zoster virus in Belgian healthcare workers: a seroprevalence study

OBJECTIVES—To assess the prevalence of varicella zoster virus (VZV) antibodies in Flemish (Belgian) healthcare workers, to investigate the association between seronegativity and selected variables, and to assess the reliability of recall about disease as a predictor of immunity.
METHODS—A seroprevalence study of VZV antibodies (IgG) was conducted among a systematic sample of 4923 employees in various professional groups, employed in 22 hospitals in Flanders and Brussels (Belgium). Information about sex, age, department, job, and years of employment, the country of origin, and history of varicella was obtained. The presence of VZV antibodies was investigated with the enzyme linked immunosorbent assay (ELISA), Enzygnost anti VZV / IgG (Dade Behring, Marburg, Germany). Statistical analysis was performed by calculating prevalences and prevalence ratios (PRs) and their 95% confidence intervals (95% CIs). Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of the recalled history were determined.
RESULTS—The prevalence of VZV seropositivity in Flemish healthcare workers was 98.5% (95% CI 98.1 to 98.8). Seronegativity was significantly associated with age and job, increasing with both older and younger age. The prevalence of seronegative workers was significantly less in nursing staff than non-nursing staff. There was no significant difference for sex and years of employment. The PPV and NPV of recalled history were 98.9% and 3.4%. Sensitivity and specificity were 83% and 38.9%.
CONCLUSION—The prevalence of VZV seropositivity was very high in this sample of Flemish healthcare workers. Because of this low overall susceptibility, VZV infection seems not to be an important occupational risk among healthcare workers in Flanders. The increasing seronegativity above the age of 45 is possibly due to a loss of detectable antibodies. A positive history of varicella was a good predictor of immunity, but a negative history had no value as a predictor of susceptibility in adults.


Keywords: varicella; healthcare workers; occupational risk     

El estado de salud de las personas mayores que sufren insomnio

Objectives

To evaluate the perceived health status of elderly patients with insomnia, whether primary, secondary to a medical illness, or associated with another mental disorder.

Methods

We conducted a cross-sectional study in a representative sample of 926 persons aged over 65 years. A psychiatric interview was used to verify the presence of insomnia (DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth ed., revised text). Interviews were conducted by health professionals to assess perceived health status (EuroQol-5D), health problems, and socio-demographic characteristics.

Results

The prevalence of primary insomnia was 8.9% (95% CI: 7.1-11.0), that of insomnia associated with another mental disorder was 9.3% (95% CI: 7.5-11.4) and that of insomnia secondary to medical illness was 7.0% (95% CI: 5.4-8.9). Patients with insomnia who used hypnotics/sedatives scored lower in self-reported health (57.6; 95% CI: 53.7-61.4), significantly lower (p < 0.05) than participants with insomnia not taking these drugs (65.1; 95% CI: 53.7-61.4). The mean health status score in individuals without insomnia was 0.87 and was significantly lower (p < 0.05) in persons with any type of insomnia: 0.80 in primary insomnia, 0.73 in insomnia secondary to a mental disorder and 0.76 in insomnia associated with medical illness.

Conclusions

Health status was worse in older people with insomnia, whether primary, secondary to other mental illnesses or organic, and when the elderly patients consumed hypnotics/sedatives. Limitations were less severe in primary insomnia.     

邢台市男性煤炭工人睡眠与肾功能异常的关系

  目的  探讨邢台市男性煤炭工人睡眠与肾功能异常之间的关系,为男性煤炭工人的肾脏疾病防治提供理论依据。  方法  采用现况研究,收集河北省邢台市2家煤炭公司的3 774名井下男性煤炭工人的问卷和血生化指标等信息。采用多因素Logistic回归分析模型分析倒班、睡眠时长和失眠或睡眠评分与肾功能异常的关系。  结果  男性工人的肾功能异常检出率为5.3%,倒班、睡眠时长≤5 h、失眠的工人占比分别为63.2%、4.0%及10.0%。调整年龄、睡眠时长、倒班状态、失眠等因素后,多因素Logistic回归分析模型分析结果显示,现在倒班(OR=1.557, 95% CI: 1.078~2.250, P=0.018)、睡眠时长≤5 h(OR=1.886, 95% CI: 1.005~3.540, P=0.048)、有睡眠问题组(OR=1.810, 95% CI: 1.286~2.546, P=0.001)与肾功能异常的联系减弱,失眠与肾功能异常联系无统计学意义(P=0.279)。根据倒班状态进行分层分析,调整相关混杂因素后发现,现在倒班的煤炭工人肾功能异常患病风险随睡眠评分等级的增加而增加(P_趋势=0.001)。  结论  每天睡眠时长≤5 h、现在倒班与男性煤炭工人肾功能异常独立相关,且睡眠问题越严重,肾功能异常的患病风险越高。     

Can social factors explain sex differences in insomnia? Findings from a national survey in Taiwan

STUDY OBJECTIVE: To examine sociological explanations for the higher level of insomnia in women, including social roles and socioeconomic status (SES). DESIGN: Cross sectional survey research SETTING: Taiwanese 2001 "social trend survey" PARTICIPANTS: A nationally representative sample of 39,588 citizens aged 15 years or older living in Taiwan. MAIN RESULTS: On average, women scored 1.25 points higher than men on the insomnia inventory (p<0.001) but after controlling for social roles, the sex discrepancy in insomnia decreased slightly. SES did not, however, explain women's higher levels of insomnia. Subscale analysis showed an association between the role of homemaker and increased night time sleep disturbance and decreased daytime sequelae of poor sleep while higher educational attainment was related only to more severe daytime sequelae. CONCLUSION: The sex discrepancy in insomnia narrowed slightly after taking social role factors into consideration but was not explained by SES. The persistent sex gap in insomnia warrants further investigation.     

Sleep disorder symptoms among nurses and nursing aides

Summary Nurses and nursing aides (n = 418) currently working on a regular evening or day schedule were compared in terms of sleep disorder symptoms. The relationship between past nightwork and sleep disorder symptoms was also assessed. The prevalence of individual symptoms varied from 6 to 53%. Evening workers showed a pattern of sleep disorder compatible with sleep deprivation, whereas the pattern for day workers was more compatible with insomnia. Past nightwork was significantly associated with symptoms of day tiredness and the quantity of sleep obtained was influenced by past nightwork. The prevalence of a combination of four insomnia symptoms (initial, intermittent, and terminal insomnia and fatigue during the day) was 5.4% among current day workers but no cases were identified among evening workers. Among day workers, the trend for insomnia across levels of duration of past nightwork fell slightly short of conventional statistical significance (P = 0.09). The relationship between a combination of four symptoms was neither modified nor confounded by variables such as age, chronotype, intensity of past nightwork, and latency. In conclusion, although some sleep symptoms were associated with nightwork, a clear residual effect on a combination of symptoms could not be shown.This project was supported by a grant from L'Institut de Recherche en Sante et Securite du Travail du Quebec     

The prevalence and correlates of occupational injuries in small-scale manufacturing enterprises

Workers involved in small-scale manufacturing businesses are known to comprise a high-risk population for occupational injury. The present study investigated the prevalence and correlates of occupational injury in this population. A self-administered questionnaire that solicited answers about occupational information including injury, demographic characteristics, health conditions and lifestyle factors was collected from a sample of 1,298 workers in 228 small-scale manufacturing enterprises (defined as fewer than 50 workers) aged 16-78 (mean 46) yr in Yashio city, Saitama, Japan (response rate 65.5%). The enterprises were randomly selected from the 2000 edition of the city commercial directory corresponding to the distribution of types of businesses in the city. Occupational injury was assessed by asking subjects, ;Have you ever been injured during your work, including minor scratches and cuts in the previous 1-yr period?' The possible response was either ;yes' or ;no.' The prevalence of study-defined occupational injury among the workers was 35.6% (male 43.0%, female 17.9%). Among job types, manufacturing (44.2%) and driving (43.5%) had high rates of occupational injuries. Similarly, occupational injuries were high in the papermaking (54.5%) and machinery (47.7%) industries. For males, younger age, current or former smoking, insomnia symptoms, and disease(s) currently under treatment were correlated with injury, whereas for females, being unmarried, higher educational status, and insomnia symptoms were the correlating factors. Occupational injury is common among small-scale manufacturing businesses, and is associated with multiple controllable factors. Countermeasures such as prohibiting smoking during work, sleep health education, job safety training for young/inexperienced workers are appropriate methods for eliminating or reducing injuries.     

A pilot study examining if satisfaction of basic needs can ameliorate negative effects of shift work

The objective of the present study was to investigate if satisfaction of the basic needs of autonomy, competence, and relatedness is related to shift work tolerance, specifically physical and mental fatigue, insomnia, and digestive troubles in a sample of shift workers. This is a cross-sectional pilot questionnaire study, including 252 shift workers employed in a municipality in Norway. Autonomy was negatively related to physical fatigue and digestive troubles, while competence was negatively related to mental fatigue. Relatedness showed significant correlations with insomnia and mental fatigue, but did not reach significance in the regression model controlling for the two other basic needs as well as work scheduling, night work exposure, and sleep medication. Sleep medication was significant in the final regression model for insomnia, but unrelated to fatigue and digestive troubles. The demographic variables, work hours per week, work schedule, and night work exposure were unrelated to all four measures of shift work tolerance. Autonomy and competence may be more important for fatigue and digestive troubles among shift workers than work arrangement variables, night work exposure, and sleep medication use.     

Associations of Protein,Fat, and Carbohydrate Intakes With Insomnia Symptoms Among Middle-aged Japanese Workers

Background

Diet is a modifiable factor that may affect sleep, but the associations of macronutrient intakes with insomnia are inconsistent. We investigated the associations of protein, fat, and carbohydrate intakes with insomnia symptoms.

Methods

In this cross-sectional analysis of 4435 non-shift workers, macronutrient intakes were assessed by the brief-type self-administered diet history questionnaire, which requires the recall of usual intakes of 58 foods during the preceding month. Presence of insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and poor quality of sleep (PQS) were self-reported. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs adjusted for demographic, psychological, and behavioral factors, as well as medical histories.

Results

Low protein intake (<16% vs ≥16% of total energy) was associated with DIS (OR 1.24, 95% CI 0.99–1.56) and PQS (OR 1.24, 95% CI 1.04–1.48), while high protein intake (≥19% vs <19% of total energy) was associated with DMS (OR 1.40, 95% CI 1.12–1.76). Low carbohydrate intake (<50% vs ≥50% of total energy) was associated with DMS (OR 1.19, 95% CI 0.97–1.45).

Conclusions

Protein and carbohydrate intakes in the daily diet were associated with insomnia symptoms. The causality of these associations remains to be explained.Key words: difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), poor quality of sleep (PQS), cross-sectional study