摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者焦虑和抑郁状态的影响因素。方法选2013年5月至2015年11月于中国医科大学附属第一医院呼吸科睡眠中心经多导睡眠监测诊断为OSAHS的患者196例,其中重度OSAHS患者103例,轻中度OSAHS患者93例。根据Epworth嗜睡量表(ESS)评分和嗜睡症状将患者分为OSAHS合并白日嗜睡(EDS)者和未合并EDS者,收集患者的一般资料、症状,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价患者情绪状况,采用匹兹堡睡眠质量指数(PSQI)评价患者的主观睡眠质量。比较合并EDS与未合并EDS的OSAHS患者焦虑和抑郁评分,并进行相关因素分析。结果(1)重度OSAHS患者中,合并EDS者较未合并EDS者PSQI评分[(6.22±2.57)分比(4.05±3.72)分,P<0.01]、氧减指数[(57.70±17.53)次/h比(48.23±22.01)次/h,P<0.05]明显增高;(2)无论是重度还是轻中度OSAHS患者,合并EDS时均具有较高的SAS评分[重度:(33.86±7.60)分比(28.95±4.71)分,轻中度:(37.46±10.68)分比(33.40±11.07)分,P<0.05]、SDS评分[重度:(32.81±8.36)分比(28.90±4.53)分,轻中度:(36.98±12.77)分比(31.70±10.94)分,P<0.05];(3)多因素线性回归分析显示,SAS评分与ESS评分、PSQI、失眠程度、鼻塞程度相关(R2=0.356,P<0.05);SDS评分与ESS评分、PSQI、失眠程度相关(R2=0.344,P<0.05)。结论OSAHS患者的焦虑和抑郁状态与白日嗜睡程度和睡眠质量密切相关,无论是重度还是轻中度OSAHS患者,合并EDS时焦虑和抑郁评分明显增高。
ObjectiveTo explore the factors that contribute to the anxiety and depression in obstructive sleep apnea hypopnea syndrome (OSAHS) patients in terms of excessive daytime sleepiness (EDS) and sleep quality. MethodsA total of 196 OSAHS patients, including 103 severe patients and 93 mild-moderate patients, were enrolled. Polysomnography was carried on at the sleep center of the First Hospital of China Medical University between May 2013 and November 2015. According to the Epworth sleepiness scale (ESS) and the subject daytime sleepiness symptom, all patients were divided into EDS group and non-EDS group. The patients′ general information and subjective symptoms were recorded. Emotional states were assessed with self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Sleep quality was evaluated with Pittsburgh sleep quality index (PSQI). The anxiety and depression related factors were studied by regression analysis. Results(1) In severe OSAHS group, the patients with EDS showed higher PSQI(6.22±2.57 vs. 4.05±3.72, P<0.01) and oxygen desaturation index(ODI)[(57.70±17.53) events/h vs. (48.23±22.01) events/h, P<0.05] when compared with those without EDS. (2) In both severe and mild-moderate OSAHS groups, the patients with EDS presented higher SAS scores (severe: 33.86±7.60 vs.28.95±4.71, mild-moderate: 37.46±10.68 vs. 33.40±11.07, P<0.05) and SDS scores (severe: 32.81±8.36 vs. 28.90±4.53, mild-moderate:36.98±12.77 vs. 31.70±10.94, P<0.05) when compared with those without EDS. (3) The multiple regression analysis showed that the SAS scores were related to ESS, PSQI, insomnia and nasal obstruction (R2=0.356, P<0.05), and the SDS scores were related to ESS, PSQI and insomnia(R2=0.344, P<0.05). ConclusionsThe anxiety and depression of OSAHS patients are closely related to the severity of EDS and sleep quality. Both severe and mild-moderate OSAHS patients with EDS have worse anxiety and depression scores.
作者
齐奇
王玮
申慧
秦铮
王玲
徐家欢
李文扬
祁唯一
康健
Qi Qi;Wang Wei;Shen Hui;Qin Zheng;Wang Ling;Xu Jiahuan;Li Wenyang;Qi Weiyi;Kang Jian(The Department of Respiratory,The First Hostipal of China Medical University,Shenyang 110001,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2019年第2期119-124,共6页
Chinese Journal of Internal Medicine
基金
国家重点研发计划资助(2016YFC1304500)
辽宁省特聘教授(辽教发[2015]153号)
2013年辽宁省高等学校创新团队(LT2013015).
关键词
睡眠呼吸暂停
阻塞性
白日嗜睡
焦虑
抑郁
多导睡眠监测
Sleep apnea, obstructive
Excessive daytime sleepiness
Anxiety
Depression
Polysomnography
