高原驻防部队官兵睡眠情况调查及其与慢性高原病的相关性分析

目的 了解常驻高原部队官兵的睡眠质量情况,探讨其与慢性高原病之间的关系.方法 采用分层随机抽样的方法,从某军区高原驻防部队中抽取956名连续驻守高原6个月以上的男性军人作为高原组,同时抽取该军区在平原地区驻防的587名未进驻过高原的男性军人作为对照组.采用匹兹堡睡眠质量指数量表(PSQI)搜集研究对象的睡眠情况,采用慢性高原病(CMS)症状问卷并结合生理学检查指标确定是否存在CMS以及CMS的程度.比较高原组整体及其两个亚组(健康亚组和CMS亚组)与对照组的各项生理指标和PSQI量表评分的差异.分析高原组PSQI和CMS评分与其生理指标的相关性,及其PSQI睡眠质量各项评分与CMS评分的相关性,分析高原组中3个CMS亚组(健康、轻度、中重度)间PSQI各项分值和生理指标的差异.结果 高原组的收缩压、心率和血红蛋白浓度均明显高于对照组(P<0.05),血氧饱和度明显低于对照组(P<0.05);高原组PSQI各指标分值均明显高于对照组(P<0.05).在高原组中,健康亚组和CMS亚组的收缩压、心率、血氧饱和度和血红蛋白浓度均明显高于对照组(P<0.05),且CMS亚组的舒张压明显高于对照组(P<0.05);除催眠药物应用这一指标外,高原组中健康亚组和CMS亚组的PSQI各指标均明显高于对照组(P<0.05).在高原组中,睡眠时间分值与收缩压呈明显负相关(P<0.05),睡眠效率分值与心率呈明显负相关(P<0.05),睡眠时间分值与血氧饱和度呈明显正相关(P<0.05);CMS评分与收缩压、舒张压、心率、血红蛋白浓度呈明显正相关(P<0.05),与血氧饱和度呈明显负相关(P<0.05);除催眠药物应用这一指标外,PSQI各项评分与CMS评分均呈明显正相关(P<0.05).在高原组的3个亚组中,轻度和中重度CMS亚组的血氧饱和度明显低于健康亚组(P<0.05),而血红蛋白浓度明显高于健康亚组(P<0.05);轻度、中重度CMS亚组睡眠障碍、PSQI总分分值明显高于健康亚组(P<0.05),而中重度CMS亚组的睡眠质量、睡眠时间、睡眠效率和日间功能紊乱分值明显高于健康亚组和轻度CMS亚组(P<0.05).结论 常驻高原部队官兵的睡眠质量与对照组比较明显降低,不仅与高原生活工作经历有关,也与CMS相关.随着CMS症状的加重,睡眠质量不断下降,尤以睡眠效率、睡眠障碍、PSQI总分分值的下降为著.在改善常驻高原部队官兵睡眠质量的同时须加强对CMS的防治.

Studies on sleep status of plateau garrison troops and chronic mountain sickness: A correlation analysis

Objective To investigate the sleep status of troops stationed in highland areas, and approach its correlation with chronic mountain sickness (CMS). Methods Stratified-random sampling method was employed and 956 male soldiers stationed in plateau for more than 6 consecutive months were selected from a garrison troops as the study objects (plateau group), and 587 male soldiers from the same garrison troops stationed at plain areas without any experience of highland garrison were selected as the control group. Pittsburgh Sleep Quality Index (PSQI) was employed to collect the sleep status of the soldiers and CMS symptom questionnaire combined with physiological parameters was adopted to determine the existence of CMS and its severity. Physiological parameters and PSQI scores were studied and compared between soldiers in the plateau group as well as its two subgroups (healthy subgroup and CMS subgroup) and those in the control group. Correlation analysis between PSQI and CMS scores and physiological parameters, as well as between PSQI of sleep quality and CMS scores of soldiers stationed at plateau were carried out. Differences of PSQI scores and physiological parameters among the three CMS subgroups (healthy subgroup, mild subgroup and moderate and severe subgroup) were analyzed. Results The systolic blood pressure (SBP), heart rate (HR) and hemoglobin (Hb) concentration were significantly higher (P<0.05), while the oxyhemoglobin (SpO2) was significantly lower in plateau group than in control group (P<0.05). All the PSQI scores were higher in plateau group than in control group (P<0.05). Among the soldiers in plateau group, the SBP, HR, SpO2 and Hb concentration were significantly higher in those of healthy subgroup and the CMS subgroup than those in the control group (P<0.05). Meanwhile, the diastolic blood pressure (DBP) was significantly higher in soldiers of the CMS subgroup than those in the control group (P<0.05). Except for the index of sleep medication, other PQSI indexes were all significantly higher in both healthy subgroup and CMS subgroup of the plateau group than in those of the control group (P<0.05). In the plateau group, significantly negative correlation was found between the scores of sleep time and SBP, and of sleep efficiency and HR (P<0.05);while significantly positive correlation was found between the scores of sleep time and arterial oxyhemoglobin (SpO2, P<0.05). CMS score showed significantly positive correlation with SBP, DBP, HR and Hb concentration (P<0.05), while significantly negative correlation with SpO2 (P<0.05). Except for the index of sleep medication, all the PSQI scores were significantly positively correlated with CMS score (P<0.05). For soldiers in the three CMS subgroups of the plateau group, the SpO2 was significantly lower (P<0.05), while the Hb concentration was significantly higher in the mild subgroup and the moderate and severe subgroup than in those of the healthy subgroup (P<0.05). Sleep disorder and PSQI total scores were significantly higher in the mild subgroup and the moderate and severe subgroup than in those of the healthy subgroup (P<0.05). Scores of sleep quality, sleep time, sleep efficiency and daily dysfunction were significantly higher in the moderate and severe subgroup than in those of the healthy subgroup and the mild subgroup (P<0.05). Conclusions Sleep quality of soldiers continuously stationed in plateau is significantly worse than those of control group because not only of the plateau life and work experience, but also of the CMS. Sleep quality, especially the sleep efficiency, sleep disorders and PSQI total score get worse with the increased severity of CMS. Prevention and treatment of CMS should be strengthened when improving the sleep quality of soldiers stationed at plateau.