Terzano Mario Giovanni, Parrino Liborio, Cirignotta Fabio, Ferini-Strambi Luigi, Gigli Gianluigi, Rudelli Giuseppa, Sommacal Sergio
Sleep Disorders Center, University of Parma, Via del Quartiere 4, Parma 43100, Italy.
Sleep Med. 2004 Jan;5(1):67-75. doi: 10.1016/j.sleep.2003.09.006.
To carry out an observational epidemiological survey (Studio Morfeo), to determine: (1) the frequency of insomnia in a large Italian population presenting directly to the general physician (GP); (2) the impact of insomnia on the quality of life, on the use of health-care resources and on co-morbidity.
The study was accomplished by GPs, trained by sleep specialists accredited by the Italian Association of Sleep Medicine. Only patients spontaneously presenting to their GP for medical problems were surveyed. Each GP was asked to enroll at least five patients across a routine week of medical activity including both morning and afternoon clinics. The first patient of each weekday was recruited after obtaining written consent. According to the responses to the sleep-related questions, patients were classified into three categories: (1) no insomnia, (2) level 1 insomnia with absence of day-time dysfunction and (3) level 2 insomnia with presence of day-time dysfunction.
A total of 3284 patients were enrolled by 738 GPs in this Italian survey. Insomnia was reported by 64% of all interviewed patients, with 20% classified as level 1 and 44% as level 2. Logistic analysis indicated that depression (odds ratio, 2.70), involvement of >1 organ systems (odds ratio, 1.24), female gender (odds ratio, 1.19), unemployment (odds ratio, 1.18), low education (odds ratio, 1.18) and increasing age (odds ratio, 1.02) were the major risk factors for insomnia.
Our findings indicate that insomnia is a frequent disturbance in the Italian primary care population, is associated with high risk of co-morbid conditions, and results in increased use of health-care resources.
开展一项观察性流行病学调查(莫尔费奥研究),以确定:(1)直接就诊于全科医生(GP)的意大利大量人群中失眠的发生率;(2)失眠对生活质量、医疗资源使用及合并症的影响。
该研究由经意大利睡眠医学协会认证的睡眠专家培训的全科医生完成。仅对因医疗问题自发就诊于其全科医生的患者进行调查。要求每位全科医生在包括上午和下午门诊的常规医疗活动周内至少招募5名患者。每个工作日的第一名患者在获得书面同意后入选。根据对与睡眠相关问题的回答,患者被分为三类:(1)无失眠;(2)1级失眠且无日间功能障碍;(3)2级失眠且有日间功能障碍。
在这项意大利调查中,738名全科医生共招募了3284名患者。所有受访患者中有64%报告有失眠,其中20%被分类为1级,44%为2级。逻辑分析表明,抑郁(比值比,2.70)、累及>1个器官系统(比值比,1.24)、女性(比值比,1.19)、失业(比值比,1.18)、低教育水平(比值比,1.18)和年龄增长(比值比,1.02)是失眠的主要危险因素。
我们的研究结果表明,失眠在意大利初级保健人群中是一种常见的困扰,与合并症的高风险相关,并导致医疗资源使用增加。