Bellia Vincenzo, Catalano Filippo, Scichilone Nicola, Incalzi Raffaele Antonelli, Spatafora Mario, Vergani Carlo, Rengo Franco
Istituto di Medicina Generale e Pneumologia, University of Palermo, Italy.
Sleep. 2003 May 1;26(3):318-23. doi: 10.1093/sleep/26.3.318.
Our objectives were to test the hypothesis that, in the geriatric population, chronic airway obstruction is associated with a higher prevalence of sleep disturbances; to identify the main correlates of sleep disturbances, and to verify whether asthma and COPD patients have different patterns of sleep disturbances.
The EPESE questionnaire was administered to 734 patients aged 65 years and over with asthma or chronic obstructive pulmonary disease (cases) and 1237 individuals of comparable age who were free of respiratory disease but not of other chronic conditions (controls). Four sleep disturbances were quantified: difficulty in falling asleep, nocturnal awakening, morning tiredness, and early awakening. Multidimensional assessment of demographic data, personal history, clinical, and functional status was performed. Independent correlates of sleep disturbances were identified by logistic regression analysis.
One or more sleep disturbances were reported by 445 cases and 697 controls (60.6% vs. 56.4%, ns). Morning tiredness and early awakenings were more prevalent among cases (38% vs. 27.8%, p < 0.001, and 35.1% vs. 28%, p < 0.001, respectively). Depression, as assessed by the 15-item Geriatric Depression Scale, was the most significant independent correlate for all sleep scores. Both being a case and having arthritis were independent correlates of three out of the four sleep disturbances.
Selected sleep disturbances are more common among elderly patients with chronic airway diseases than in those with chronic non-respiratory diseases. Depressed mood and coexisting arthritis are the most relevant independent correlates of sleep disturbances.
我们的目的是检验以下假设，即在老年人群中，慢性气道阻塞与睡眠障碍的较高患病率相关；确定睡眠障碍的主要相关因素，并验证哮喘和慢性阻塞性肺疾病（COPD）患者是否有不同的睡眠障碍模式。
对734例年龄在65岁及以上的哮喘或慢性阻塞性肺疾病患者（病例组）以及1237名年龄相仿、无呼吸道疾病但有其他慢性疾病的个体（对照组）进行了流行病学研究建立社区老年人健康与环境调查（EPESE）问卷。对四种睡眠障碍进行了量化：入睡困难、夜间觉醒、早晨疲倦和早醒。对人口统计学数据、个人病史、临床和功能状态进行了多维度评估。通过逻辑回归分析确定睡眠障碍的独立相关因素。
445例病例组和697例对照组报告了一种或多种睡眠障碍（60.6%对56.4%，无显著性差异）。病例组中早晨疲倦和早醒更为普遍（分别为38%对27.8%，p<0.001；35.1%对28%，p<0.001）。根据15项老年抑郁量表评估，抑郁是所有睡眠评分中最显著的独立相关因素。作为病例组以及患有关节炎都是四种睡眠障碍中三种的独立相关因素。
特定的睡眠障碍在患有慢性气道疾病的老年患者中比在患有慢性非呼吸道疾病的患者中更为常见。情绪低落和并存的关节炎是睡眠障碍最相关的独立相关因素。
