Department of Cardiology, Kärnsjukhuset, Skövde Hospital, Skövde, Sweden.
J Clin Nurs. 2011 Oct;20(19-20):2787-801. doi: 10.1111/j.1365-2702.2011.03787.x. Epub 2011 Jul 22.
To evaluate whether there are gender differences in insomnia, sleep quality, sleep efficiency (%), general arousal, disease-specific and health-related quality of life in patients with coronary artery disease, compared with an age- and gender-matched randomly selected group from the general population.
There are gender difference effects of sleep disturbances in the general population, but this perspective among patients with coronary artery disease has been poorly analysed.
In this prospective study, comparative, descriptive and model testing designs were used.
The patients with coronary artery disease, 556 men and 324 women aged 25-86, were compared with a matched population-based group. Data were collected by validated and reliability-tested questionnaires.
The prevalence of severe insomnia varied between 17-44% in all four groups. The severe insomniac coronary artery disease patients displayed a two- or threefold higher presleep arousal, had two hours shorter nocturnal sleep duration/night and were more limited in their physical exercise level than the population-based group. Gender differences in sleep quality, sleep efficiency (%) and general arousal disappeared with increased insomnia severity.
Independent of gender, age and comorbidity, physical exercise, general arousal behaviour and delayed poststress recovery after mental stress were found to have a negative impact on the coronary artery disease patients' sleep quality and sleep efficiency (%), interfering with their health-related quality of life. The variables significantly explained 41% of the sleep quality outcome and 29% of the sleep efficiency (%).
Insomnia because of hyperarousal behaviour can be an important factor in the development of an individual self-care management programme supported by a healthcare team.
评估与年龄和性别匹配的随机选择的一般人群相比，冠心病患者的失眠、睡眠质量、睡眠效率（%）、总体觉醒、疾病特异性和健康相关生活质量是否存在性别差异。
在一般人群中，睡眠障碍存在性别差异效应，但这一观点在冠心病患者中分析得还不够。
在这项前瞻性研究中，使用了对比、描述和模型测试设计。
将 556 名男性和 324 名年龄在 25-86 岁的冠心病患者与匹配的基于人群的对照组进行比较。通过经过验证和可靠性测试的问卷收集数据。
所有四组严重失眠的患病率在 17-44%之间。严重失眠的冠心病患者的入睡前觉醒程度高出两倍或三倍，夜间睡眠时间/夜晚缩短两小时，并且身体锻炼水平受限程度高于基于人群的对照组。随着失眠严重程度的增加，睡眠质量、睡眠效率（%）和总体觉醒方面的性别差异消失。
独立于性别、年龄和合并症，身体锻炼、总体觉醒行为以及心理应激后应激恢复延迟对冠心病患者的睡眠质量和睡眠效率（%）产生负面影响，干扰其健康相关生活质量。这些变量显著解释了 41%的睡眠质量结果和 29%的睡眠效率（%）。
由于过度觉醒行为导致的失眠可能是个人自我保健管理计划的重要因素，该计划由医疗保健团队提供支持。
