Kim Won-Hyoung, Jung Han-Young, Choi Ha-Yoon, Park Chan-Hyuk, Kim Eun-Suk, Lee Sook-Joung, Ko Sung-Hwa, Kim Soo-Yeon, Joa Kyung-Lim
Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea.
Department of Physical Medicine and Rehabilitation, Inha University Hospital, Incheon, Republic of Korea.
J Psychosom Res. 2017 May;96:10-14. doi: 10.1016/j.jpsychores.2017.02.008. Epub 2017 Feb 21.
The principal objective of this study was to investigate the relationship between insomnia and health-related quality of life (HRQoL) during the early stage of stroke rehabilitation.
The subjects were 214 first-time stroke patients admitted to a rehabilitation unit at one of three Korean hospitals. Within 7days after stroke, functions were evaluated using; the Berg Balance Scale, the Modified Barthel Index, the Mini Mental State Examination, the Frontal Assessment Battery, Screening Tests for Aphasia and Neurologic-Communication Disorders, and the National Institute of Health Stroke Scale. Insomnia, depression, anxiety, and HRQoL were investigated at one month after stroke. Insomnia was defined as presence of at least one of the four following; difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and non-restorative sleep. HRQoL was assessed using the Short Form Health survey SF-8. Depression and anxiety were measured using the Hospital Anxiety Depression Scale. Multivariate linear regression analysis was conducted to examine the association between insomnia and HRQoL.
The prevalence of insomnia at one month after stroke was 59.5%. Patients with insomnia were more likely to be older and female and to have depression and anxiety. Patients with insomnia had poorer physical and mental HRQoL. By multivariate analyses, physical HRQoL was significantly associated with type of stroke, hypnotic usage, balancing function, and insomnia. Mental HRQoL was significantly associated with balancing function, depression, and insomnia.
Insomnia was found to be negatively associated with physical and mental HRQoL in stroke patients during the early stage of rehabilitation.
本研究的主要目的是调查中风康复早期失眠与健康相关生活质量（HRQoL）之间的关系。
研究对象为214例首次中风患者，他们被收治于韩国三家医院之一的康复科。中风后7天内，使用伯格平衡量表、改良巴氏指数、简易精神状态检查表、额叶评估量表、失语症和神经沟通障碍筛查测试以及美国国立卫生研究院卒中量表对患者功能进行评估。在中风后1个月调查失眠、抑郁、焦虑和健康相关生活质量情况。失眠定义为存在以下四种情况中的至少一种：入睡困难、睡眠维持困难、早醒和无恢复感的睡眠。使用简短健康调查问卷SF-8评估健康相关生活质量。使用医院焦虑抑郁量表测量抑郁和焦虑。进行多变量线性回归分析以检验失眠与健康相关生活质量之间的关联。
中风后1个月失眠的患病率为59.5%。失眠患者更可能年龄较大、为女性，且患有抑郁和焦虑。失眠患者的身心健康相关生活质量较差。通过多变量分析，身体方面的健康相关生活质量与中风类型、催眠药物使用、平衡功能和失眠显著相关。心理方面的健康相关生活质量与平衡功能、抑郁和失眠显著相关。
发现在康复早期，中风患者的失眠与身心健康相关生活质量呈负相关。
