不同睡眠障碍类型对帕金森病患者生活质量的影响

目的分析帕金森病(PD)患者不同睡眠障碍类型对其生活质量的影响,为临床干预提供依据。方法应用中文版39项帕金森病生活质量问卷(PDQ-39)评定92例PD患者生活质量。采用Epworth嗜睡评分量表、香港版REM睡眠行为异常问卷(RBDQ-HK)、PD非运动症状问卷(NMSQuest)第4项和第6项、匹兹堡睡眠质量指数量表中第10项分别评定患者白天过度嗜睡(EDS)、快速动眼睡眠行为障碍(RBD)、失眠、不宁腿综合征(RLS)、睡眠呼吸暂停(SDB)等情况。分析不同睡眠障碍类型对PD患者生活质量的影响。结果伴睡眠障碍的PD患者PDQ-39评分明显高于不伴睡眠障碍的PD患者(P0.05)。在各类睡眠障碍中,失眠为PD患者生活质量最强的预测因子(r2=0.138,P=0.000),其次是RLS(r2=0.040,P=0.000),H-Y分级亦有预测作用,3者对PDQ-39总分的影响占决定作用的52%。RBD、EDS、SDB对PD患者生活质量的影响不明显。结论睡眠障碍可明显降低PD患者生活质量,其中失眠影响最显著,RLS次之。

Influence of sleep disorders on health-related quality of life in the patients with Parkinson's disease

Objective To explore the influence of sleep disorders on health-related quality of life (HRQOL) in the patients with Parkinson's disease (PD).Methods 92 consecutive PD patients were assessed for HRQOL by 39-item Parkinson's disease questionnaire (PDQ-39).Excessive daytime sleepiness (EDS),rapid eye movement sleep behavior disease (RBD),insomnia,restless legs syndrome (RLS) and sleep-disordered breathing (SDB) were evaluated via Epworth Sleep Scale (ESS),REM Sleep Behavior Disorder Questionnaire (RBDQ-HK),the question 4 and question 6 of PD NMS Questionnaire,and the question 10 in the Pittsburgh Sleep Quality Index.Stepwise multiple linear regression analysis was used to investigate the influence of different sleep disorders on the patient's HRQOL.Results The PDQ-39 score was significantly higher in PD patients with sleep disorders than patients without sleep disorders.The major influencing factors of low HRQOL were insomnia (r2 =0.138,P=0.000) and RLS (r2 =0.04,P=0.008).The predominant predictors in this study explained 52％ of the variation of the PDQ-39 summary index score,but RBD,EDS,and SDB were not the significant predictors of HRQOL.Conclusions Sleep disorders are associated with low HRQOL,insomnia may be the strongest independent predictor of low HRQOL,RLS comes second.