DiNapoli Elizabeth A, Gebara Marie Anne, Kho Terry, Butters Meryl A, Gildengers Ariel G, Albert Steven M, Dew Mary Amanda, Erickson Kirk I, Reynolds Charles F, Karp Jordan F
1 VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
2 Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Geriatr Psychiatry Neurol. 2017 Nov;30(6):316-323. doi: 10.1177/0891988717731827. Epub 2017 Sep 27.
BACKGROUND/OBJECTIVES: We investigated the prevalence and correlates of discrepancies between self-reported sleep quality (Pittsburgh Sleep Quality Index) and objective sleep efficiency (actigraphy) in older adults with mild cognitive impairment (MCI) and subsyndromal depression.
This was a secondary analysis of a clincial trial with 59 adults aged 60 years and older with MCI and subsyndromal depression. We included baseline data on participants' subjective sleep quality, objective sleep efficiency, depressive symptoms, insomnia diagnosis, and cognitive functioning.
Pittsburgh Sleep Quality Index subjective sleep quality and actigraphy-measured sleep efficiency were not significantly correlated ( r = -.06; P = .64), with 61% of participants having subjective-objective sleep discrepancies. Correlates of subjective-objective sleep discrepancy included the presence of an insomnia diagnosis and impaired memory, particularly delayed memory.
These findings are important because subjective underestimation of symptoms in older adults with memory impairments may result in sleep disturbances going unrecognized in clinical practice; on the other hand, an insomnia disorder may be a possible remediable contribution to subjective overestimation of sleep disturbances.
背景/目的：我们调查了轻度认知障碍（MCI）和亚综合征性抑郁的老年人自我报告的睡眠质量（匹兹堡睡眠质量指数）与客观睡眠效率（活动记录仪）之间差异的患病率及其相关因素。
这是一项对59名60岁及以上患有MCI和亚综合征性抑郁的成年人进行的临床试验的二次分析。我们纳入了参与者主观睡眠质量、客观睡眠效率、抑郁症状、失眠诊断和认知功能的基线数据。
匹兹堡睡眠质量指数主观睡眠质量与活动记录仪测量的睡眠效率无显著相关性（r = -0.06；P = 0.64），61%的参与者存在主观-客观睡眠差异。主观-客观睡眠差异的相关因素包括失眠诊断的存在和记忆受损，尤其是延迟记忆受损。
这些发现很重要，因为记忆受损的老年人对症状的主观低估可能导致临床实践中睡眠障碍未被识别；另一方面，失眠症可能是导致对睡眠障碍主观高估的一个可能可补救的因素。
