Lasisi Akeem O, Gureje Oye
Department of Otorhinolaryngology, University of Ibadan, Ibadan, Nigeria.
Ann Otol Rhinol Laryngol. 2011 Apr;120(4):226-30. doi: 10.1177/000348941112000402.
We sought to determine the prevalence of insomnia and its impact on the quality of life (QoL) among community elderly subjects (at least 65 years of age) with subjective tinnitus.
After household selection with multistage stratified area probability sampling, face-to-face interviews were used to obtain self-reports of subjective tinnitus and insomnia, and QoL was assessed with the WHOQoL-Bref instrument.
Among 1302 elderly subjects, there were 183 subjects (109 female and 74 male) with tinnitus. Among those with tinnitus, insomnia was encountered in 95 (51.9%) and was found to be significantly more common among those with tinnitus than among those without (378 of 1119, or 33.8%; p = 0.002). The insomnia symptoms included difficulty in maintaining sleep in 73.4% of subjects, difficulty in falling asleep in 70.0%, early morning wakefulness in 64.3%, nonrestorative sleep in 35.1%, and daytime sleepiness in 34.7%. Univariate analysis revealed difficulty with falling asleep (p = 0.01) and early morning wakefulness (p = 0.05) to be significantly associated with tinnitus among the symptoms. Student's t-test and logistic regression analysis revealed significant deterioration in the total QoL and in the physical, psychological, social, and environmental QoL domains among elderly subjects who had tinnitus with insomnia as compared with those without insomnia.
We believe that insomnia is significantly more common among elderly subjects with tinnitus than among those without, and that its presence further depreciates the QoL in these elderly individuals.
我们试图确定社区中患有主观性耳鸣的老年受试者(至少65岁)失眠的患病率及其对生活质量(QoL)的影响。
采用多阶段分层区域概率抽样进行家庭选择后,通过面对面访谈获取主观性耳鸣和失眠的自我报告,并使用世界卫生组织生活质量简表(WHOQoL-Bref)评估生活质量。
在1302名老年受试者中,有183名受试者(109名女性和74名男性)患有耳鸣。在这些耳鸣患者中,95名(51.9%)存在失眠,且发现耳鸣患者中的失眠明显比无耳鸣者更常见(1119名中的378名,即33.8%;p = 0.002)。失眠症状包括73.4%的受试者难以维持睡眠、70.0%难以入睡、64.3%清晨觉醒、35.1%睡眠无恢复感以及34.7%白天嗜睡。单因素分析显示,在这些症状中,入睡困难(p = 0.01)和清晨觉醒(p = 0.05)与耳鸣显著相关。学生t检验和逻辑回归分析显示,与无失眠的耳鸣老年受试者相比,患有耳鸣且失眠的老年受试者在总体生活质量以及身体、心理、社会和环境生活质量领域均有显著恶化。
我们认为,患有耳鸣的老年受试者中失眠明显比无耳鸣者更常见,且失眠的存在进一步降低了这些老年人的生活质量。