焦虑症伴发失眠与原发性失眠患者觉醒水平比较与分析

目的对比焦虑症伴发失眠与原发性失眠患者过度觉醒水平,探讨焦虑症伴发失眠特点。方法收集并分析20例正常睡眠者、25例焦虑症伴发失眠患者及26例原发性失眠患者的心率变异性、脑电频谱、24 h尿游离皮质醇数据。结果焦虑症伴发失眠患者及原发性失眠患者心率变异性低频/高频（LF/HF）、24 h尿游离皮质醇浓度、脑电谱频theta、alpha、sigma、beta、gamma相对功率值均高于正常睡眠人群,差异有统计学意义（P〈0.05）;心率变异性高频（HF）、5 min平均心率标准差（SDANN）、RR间期标准差（SDNN）、相邻RR间期之差的均方根值（rMSSD）、爱丁堡指数（pNN50）、脑电谱频delta相对功率值均低于正常睡眠人群,差异有统计学意义（P〈0.05）。焦虑症伴发失眠患者心率变异性低频/高频（LF/HF）、24 h尿游离皮质醇浓度、脑电谱频beta、gamma相对功率值均高于原发性失眠患者,差异有统计学意义（P〈0.05）;心率变异性HF、SDANN、SDNN、rMSSD、pNN50、脑电谱频delta相对功率值低于原发性失眠患者,差异有统计学意义（P〈0.05）。结论焦虑症伴发失眠与原发性失眠患者均存在过度觉醒,其中,焦虑症伴发失眠患者过度觉醒水平比原发性失眠患者高。

Comparison and analysis of arousal level between anxiety comorbid insomnia patients and primary insomnia patients

Objective To compare the excessive arousal level between anxiety comorbid insomnia patients and primary insomnia patients,in order to explore the characteristics of anxiety comorbid insomnia.Methods 20 cases of normal sleep people,25 cases of patients with anxiety comorbid insomnia and 26 cases of patients with primary insomnia were selected and analyzed.Levels of heart rate variability,electroencephalogram spectrum,24 h urinary free cortisol among the three groups were detected and analyzed.Results Heart rate variability low frequency/high frequency(LF/HF),24 h urinary free cortisol concentration,relative power values of electroencephalogram spectrum theta,alpha,sigma,beta,gamma in anxiety comorbid insomnia patients and primary insomnia patients were significantly higher than those in normal sleep people(P<0.05);while heart rate variability HF,standard deviation of sequential 5 min RR interval(SDANN),standard deviation of RR interval(SDNN),root mean square standard deviation from adjacent RR interval(rMSSD),edinburgh index(pNN50), relative power value of electroencephalogram spectrum delta in anxiety comorbid insomnia patients and primary insomnia patients were significantly lower than those in normal sleep patients(P<0.05).Heart rate variability LF/HF,24 h urinary free cortisol concentration,relative power values of electroencephalogram spectrum beta,gamma in anxiety comorbid insomnia patients were significantly higher than those in primary insomnia patients(P<0.05);heart rate variability HF, SDANN,SDNN,rMSSD,pNN50,relative power value of electroencephalogram spectrum delta in anxiety comorbid insomnia patients were significantly lower than those in primary insomnia patients(P<0.05).Conclusion Both anxiety comorbid insomnia patients and primary insomnia patients suffer from excessive arousal,while the excessive arousal level in patients with anxiety comorbid insomnia is more serious than patients with primary insomnia.