Léger D, Scheuermaier K, Philip P, Paillard M, Guilleminault C
Centre du Sommeil, H tel-Dieu de Paris, France.
Psychosom Med. 2001 Jan-Feb;63(1):49-55. doi: 10.1097/00006842-200101000-00006.
Despite many studies, the impact of chronic insomnia on daytime functioning is not well understood. The aim of our study was to detect this impact by evaluating quality of life (QoL) using a validated instrument, the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36), in three matched groups of severe insomniacs, mild insomniacs, and good sleepers selected from the general population.
Three matched groups of 240 severe insomniacs, 422 mild insomniacs, and 391 good sleepers were recruited from the general French population after eliminating those with DSM-IV criteria for anxiety or depression. All subjects were asked to complete the SF-36. Scores for each QoL dimension were calculated and compared statistically among the three groups.
Severe insomniacs had lower QoL scores in eight dimensions of the SF-36 than mild insomniacs and good sleepers. Mild insomniacs had lower scores in the same eight dimensions when compared with good sleepers. No dimension was significantly more altered than the other.
The mental health status and role of emotional QoL dimensions were worse in severe and mild insomniacs than in good sleepers. This result held even though we screened for psychiatric diseases, which shows a clear interrelation between insomnia and emotional state. General health status was also worse in severe and mild insomniacs than in good sleepers. However, we could conclude only that insomnia was related to a worse health status and not whether it was a cause or consequence of this worse health status. Finally, the degradation of QoL scores was correlated with the severity of insomnia.
尽管已有许多研究,但慢性失眠对日间功能的影响仍未得到充分理解。我们研究的目的是通过使用一种经过验证的工具——医学结局研究36项简明健康调查问卷(SF - 36),对从普通人群中选取的三组匹配的重度失眠者、轻度失眠者和睡眠良好者进行生活质量(QoL)评估,来检测这种影响。
从法国普通人群中招募了三组匹配的受试者,分别为240名重度失眠者、422名轻度失眠者和391名睡眠良好者,排除了符合DSM - IV焦虑或抑郁标准的人。所有受试者都被要求完成SF - 36问卷。计算了每组在每个生活质量维度上的得分,并在三组之间进行统计学比较。
重度失眠者在SF - 36的八个维度上的生活质量得分低于轻度失眠者和睡眠良好者。与睡眠良好者相比,轻度失眠者在相同的八个维度上得分较低。各维度之间的改变没有显著差异。
重度和轻度失眠者的心理健康状况以及情感生活质量维度的表现比睡眠良好者更差。即使我们对精神疾病进行了筛查,这一结果仍然成立,这表明失眠与情绪状态之间存在明显的相互关系。重度和轻度失眠者的总体健康状况也比睡眠良好者更差。然而,我们只能得出失眠与较差的健康状况有关的结论,而无法确定它是这种较差健康状况的原因还是结果。最后,生活质量得分的下降与失眠的严重程度相关。