Edéll-Gustaffson Ulla M
Department of Medicine and Care, Nursing Science, Faculty of Health Sciences, Linköpings Universitet, Linköping, Sweden.
J Adv Nurs. 2002 Mar;37(5):414-22. doi: 10.1046/j.1365-2648.2002.02106.x.
To explore possible links between sleep quality, cognitive anxiety and the effects of sleep disturbances on health, daytime functioning and quality of life, for assessment in a larger study. Hypotheses were: (a) patients with coronary artery disease have insufficient sleep as measured by self-reported sleep and by polysomnography, (b) self-reported sleep is associated with polysomnographically measured sleep, (c) reduced sleep quality is associated with physical and mental health, and interferes with quality of life as measured by means of interviews and polysomnography, (d) reduced sleep quality is associated with reduced resilience to stress.
It has become increasingly evident that poor sleep with sleep initiation difficulties is an independent risk factor for cardiac events among men, and requires more attention in clinical nursing practice.
Descriptive, correlative and explorative study.
Forty-four men, aged 45-70, about to undergo coronary artery bypass surgery at a Swedish University Hospital.
Interviews and 24-hour continuous ambulatory polysomnography were performed. For the interviews, the Uppsala Sleep Inventory, Spielberger State Anxiety Scale and the Nottingham Health Profile instruments were used.
Seventeen patients (38.6%) had insufficient sleep and 12 had sleep initiation difficulties. Logistic regressions revealed that reduced stage 3-4 sleep predicted poorer overall health, initiation of sleep difficulties, predicted insufficient sleep and involuntary thoughts predicted fragmented sleep. Poorer quality of life was predicted by reduced deep sleep. Independent predictors for emotional distress were sleep efficiency below 85%, fragmented sleep and a daytime nap longer than 15 minutes.
Objective sleep was associated with several subjective sleep variables. The results provide empirical support for significant variables included in a theoretical framework relating to sleep quality, cognitive anxiety, health and quality of life. A larger study is recommended that includes both men and women.
探讨睡眠质量、认知焦虑以及睡眠障碍对健康、日间功能和生活质量的影响之间的可能联系，以便在一项更大规模的研究中进行评估。假设如下：（a）冠心病患者通过自我报告的睡眠情况和多导睡眠图测量显示睡眠不足；（b）自我报告的睡眠情况与多导睡眠图测量的睡眠情况相关；（c）睡眠质量下降与身心健康相关，并通过访谈和多导睡眠图测量干扰生活质量；（d）睡眠质量下降与应激恢复力降低相关。
越来越明显的是，入睡困难的睡眠不佳是男性心脏事件的独立危险因素，在临床护理实践中需要更多关注。
描述性、相关性和探索性研究。
44名年龄在45 - 70岁之间、即将在瑞典一家大学医院接受冠状动脉搭桥手术的男性。
进行访谈和24小时连续动态多导睡眠图监测。访谈使用了乌普萨拉睡眠量表、斯皮尔伯格状态焦虑量表和诺丁汉健康状况量表。
17名患者（38.6%）睡眠不足，12名患者存在入睡困难。逻辑回归显示，3 - 4期睡眠减少预示整体健康状况较差，入睡困难预示睡眠不足，非自主思维预示睡眠碎片化。深度睡眠减少预示生活质量较差。情绪困扰的独立预测因素是睡眠效率低于85%、睡眠碎片化以及日间小睡超过15分钟。
客观睡眠与多个主观睡眠变量相关。研究结果为一个与睡眠质量、认知焦虑、健康和生活质量相关的理论框架中包含的重要变量提供了实证支持。建议开展一项更大规模的研究，纳入男性和女性。
