现役军人的睡眠障碍及相关合并症医学。
Sleep disorders and associated medical comorbidities in active duty military personnel.
机构信息
Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA 98431, USA.
出版信息
Sleep. 2013 Feb 1;36(2):167-74. doi: 10.5665/sleep.2364.
STUDY OBJECTIVES
Describe the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders.
DESIGN
Retrospective cross-sectional study.
SETTING
Military medical treatment facility.
PARTICIPANTS
Active duty military personnel with diagnostic polysomnogram in 2010.
MEASUREMENTS
Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review.
RESULTS
Primary sleep diagnoses (n = 725) included: mild obstructive sleep apnea (OSA), 207 (27.2%); insomnia, 188 (24.7%); moderate-to-severe OSA, 183 (24.0 %); and paradoxical insomnia,39 (5.1%); behaviorally induced insufficient sleep syndrome, 68 (8.9%) and snoring, 40 (5.3%) comprised our control group. Short sleep duration (< 5 h) was reported by 41.8%. Overall 85.2% had deployed, with 58.1% having one or more comorbid diagnoses. Characteristics associated with moderate-to-severe OSA were age (adjusted odds ratio [OR], 1.03 [95% confidence interval {CI}, 1.0-1.05], sex (male) (adjusted OR, 19.97 [95% CI, 2.66-150.05], anxiety (adjusted OR, 0.58 [95% CI, 0.34-0.99]), and body mass index, BMI (adjusted OR 1.19 [95% CI, 1.13-1.25]; for insomnia, characteristics included PTSD (adjusted OR, 2.12 [95% CI, 1.31-3.44]), pain syndromes (adjusted OR, 1.48 [95%CI, 1.01-2.12]), sex (female) (adjusted OR, 0.22 [95% CI, 0.12-0.41]) and lower BMI (adjusted OR, 0.91 [95% CI, 0.87, 0.95]).
CONCLUSIONS
Service-related illnesses are prevalent in military personnel who undergo polysomnography with significant associations between PTSD, pain syndromes, and insomnia. Despite having sleep disorders, almost half reported short sleep duration. Multidisciplinary assessment and treatment of military personnel with sleep disorders and service-related illnesses are required.
CITATION
Mysliwiec V; McGraw L; Pierce R; Smith P; Trapp B; Roth BJ. Sleep disorders and associated medical comorbidities in active duty military personnel. SLEEP 2013;36(2):167-174.
研究目的
描述因多导睡眠图（polysomnogram）检查而转诊的军人中睡眠障碍的流行情况，并确定人口统计学特征、合并症诊断与特定睡眠障碍之间的关系。
设计
回顾性横断面研究。
地点
军事医疗设施。
参与者
2010 年进行诊断性多导睡眠图检查的现役军人。
测量
由经委员会认证的睡眠医学医师对多导睡眠图和病历进行审查，确定主要睡眠障碍。通过病历审查确定创伤后应激障碍（posttraumatic stress disorder，PTSD）、轻度创伤性脑损伤（mild traumatic brain injury，mTBI）、焦虑、抑郁和疼痛综合征等条件的人口统计学特征。
结果
主要睡眠诊断（n=725）包括：轻度阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA），207 例（27.2%）；失眠，188 例（24.7%）；中重度 OSA，183 例（24.0%）；矛盾性失眠，39 例（5.1%）；行为性睡眠不足综合征，68 例（8.9%）和打鼾，40 例（5.3%）为对照组。41.8%的人报告睡眠时间短（<5 小时）。总的来说，85.2%的人被部署过，58.1%的人有一个或多个合并症诊断。与中重度 OSA 相关的特征包括年龄（调整后的优势比[odds ratio，OR]，1.03[95%置信区间{confidence interval，CI}，1.0-1.05]）、性别（男性）（调整后的 OR，19.97[95% CI，2.66-150.05]）、焦虑（调整后的 OR，0.58[95% CI，0.34-0.99]）和体重指数（body mass index，BMI）（调整后的 OR，1.19[95% CI，1.13-1.25]）；对于失眠，特征包括 PTSD（调整后的 OR，2.12[95% CI，1.31-3.44]）、疼痛综合征（调整后的 OR，1.48[95% CI，1.01-2.12]）、性别（女性）（调整后的 OR，0.22[95% CI，0.12-0.41]）和较低的 BMI（调整后的 OR，0.91[95% CI，0.87,0.95]）。
结论
在因多导睡眠图检查而转诊的军人中，与兵役有关的疾病很常见，PTSD、疼痛综合征和失眠之间存在显著关联。尽管存在睡眠障碍，但近一半的人报告睡眠时间短。需要对患有睡眠障碍和与兵役有关的疾病的军人进行多学科评估和治疗。
引文
Mysliwiec V；McGraw L；Pierce R；Smith P；Trapp B；Roth BJ。现役军人的睡眠障碍及相关医学合并症。睡眠 2013；36(2):167-174.
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