Ohayon Maurice M, Paiva Teresa
Stanford Sleep Epidemiology Research Center, Stanford University School of Medicine, Stanford, CA, USA.
Sleep Med. 2005 Sep;6(5):435-41. doi: 10.1016/j.sleep.2005.03.006.
This study examines the prevalence and associated factors of insomnia symptoms and sleep dissatisfaction in the general population of Portugal.
We interviewed by telephone 1858 participants aged 18 years or older and representative of the general population of Portugal using the Sleep-EVAL system. Participation rate was 83%. The questionnaire included the assessment of sleep habits, insomnia symptomatology according to DSM-IV and ICSD classifications, associated and sleep/mental disorders and daytime consequences.
Insomnia symptoms occurring at least 3 nights per week were reported by 28.1% of the sample and global sleep dissatisfaction (GSD) by 10.1%. Difficulty maintaining sleep was the most frequent symptom (21.0%); 29.4% of subjects with insomnia symptoms reported GSD. Daytime consequences, medical consultations for sleep and use of sleep medication were at least 2 times more frequent among subjects with insomnia symptoms and GSD compared to subjects with insomnia symptoms without GSD; insomnia diagnoses were also more frequent in the GSD group.
The results show a severity gradation among subjects with only 1 insomnia symptom, those with 2 or 3 insomnia symptoms but without GSD and those with at least 1 insomnia symptom and GSD. Specific sleep or psychiatric disorders were identified for the majority of GSD subjects (86%); this rate dropped to 50.6% when only 1 insomnia symptom without GSD was reported. GSD appeared to be a good indicator of the presence of a sleep or psychiatric disorder and a good discriminator of the severity of sleep disturbances among subjects with insomnia symptoms.
本研究调查了葡萄牙普通人群中失眠症状及睡眠不满意的患病率和相关因素。
我们使用睡眠评估系统通过电话访谈了1858名年龄在18岁及以上、具有葡萄牙普通人群代表性的参与者。参与率为83%。问卷包括对睡眠习惯、根据《精神疾病诊断与统计手册》第四版（DSM-IV）和国际睡眠障碍分类（ICSD）的失眠症状学、相关睡眠/精神障碍以及日间后果的评估。
样本中28.1%的人报告每周至少有3个晚上出现失眠症状，10.1%的人报告有总体睡眠不满意（GSD）。维持睡眠困难是最常见的症状（21.0%）；29.4%有失眠症状的受试者报告有GSD。与没有GSD的失眠症状受试者相比，有失眠症状和GSD的受试者出现日间后果、因睡眠问题就医以及使用睡眠药物的频率至少高出2倍；GSD组的失眠诊断也更为常见。
结果显示，仅有1种失眠症状的受试者、有2或3种失眠症状但无GSD的受试者以及至少有1种失眠症状且有GSD的受试者之间存在严重程度分级。大多数有GSD的受试者（86%）被确定患有特定的睡眠或精神障碍；当仅报告1种无GSD的失眠症状时，这一比例降至50.6%。GSD似乎是存在睡眠或精神障碍的良好指标，也是失眠症状受试者中睡眠障碍严重程度的良好区分指标。
