骨质疏松老年患者睡眠障碍及影响因素分析

目的 分析骨质疏松老年患者睡眠障碍的影响因素。方法 采用匹兹堡睡眠质量指数量表（PSQI）评测患者的睡眠状况，使用自行设计的一般人口学资料及相关因素调查表于2014年7-12月对就诊于华北理工大学附属医院的412例骨质疏松老年患者进行调查。结果 骨质疏松老年患者PSQI得分为（8.71±5.03）分，睡眠障碍者占50.0%；单因素分析显示，女性（52.9%）、离异或丧偶（69.9%）、从事体力劳动（54.9%）、月收入1 000～1 999元（58.7%）、骨质疏松程度严重（68.3%）、继发性骨质疏松（56.3%）、疼痛（55.7%）、疼痛程度重（71.9%）、自感乏力（63.7%）、肌肉痉挛（59.1%）、脊椎压缩变形（60.5%）、自评健康差（68.9%）、自理能力差（78.5%）、焦虑（83.3%）、抑郁（89.7%）患者睡眠障碍率较高（P<0.05）；多因素logistic回归分析结果显示，体力劳动（OR=2.168）、离异或丧偶（OR=2.461）、骨质疏松程度重（OR=2.419）、疼痛程度中度以上（OR=5.740）、自感乏力（OR=3.902）、肌肉痉挛（OR=1.923）、抑郁情绪（OR=8.120）是骨质疏松老年患者睡眠障碍的危险因素，进行抗骨质疏松治疗（OR=0.334）是骨质疏松老年患者睡眠障碍的保护因素。结论 应重视患者自身疾病及心理状况的治疗，降低睡眠障碍的发生，提高健康水平。

Influencing factors of sleep disorders among the elderly with osteoporosis

Objective To explore influencing factors of sleep disorder in the elderly with osteoporosis (OP).Methods A questionnaire survey was conducted among elderly OP patients (aged ≥60 years) seeking medication at the Hospital Affiliate to North China University of Science and Technology during July to December,2014.Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep condition and a self-compiled questionnaire was used to collect related information among the patients.Results The average PSQI score was 8.71±5.03 and 50.0% of the elderly had sleep disorders (PSQI score>7).Univariate analysis showed that the prevalence of sleep disorders was significantly higher among the elderly OP patients of female (52.9%),divorced or widowed (69.9%),engaged in manual labor (54.9%),having a monthly income of 1 000-1 999 yuan RMB (58.7%),with severe osteoporosis (68.3%),secondary osteoporosis (56.3%),pain (55.7%),severe pain (71.9%),fatigue (63.7%),muscle spasm (59.1%),vertebral compression (60.5%),poor self-rated health(68.9%),poor self-care (78.5%),anxiety (83.3%),and depression (89.7%) (all P<0.05).Multivariate logistic regression confirmed that the influencing factors of sleep disorders in the elderly OP patients were manual labor (odds ratio[OR]=2.168),divorced or widowed(OR=2.461),severe OP (OR=2.419),moderate and severe pain(OR=5.740),feeling of fatigue (OR=3.902),muscle cramps (OR=1.923),and depression (OR=8.120);while receiving treatment for OP was a protective factor (OR=0.334).Conclusion We should pay attentions to the treatment of underlying diseases and psychological conditions to reduce the incidence of sleep disorders among elderly OP patients.