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综合内科病房住院患者新发失眠情况:发病率、病因及缓解率。

New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate.

作者信息

Ho An, Raja Bronson, Waldhorn Richard, Baez Valentina, Mohammed Idiris

机构信息

Medicine Department, Medstar Harbor Hospital, Baltimore, MD, USA.

Pulmonary and Critical Care Department, Medstar Georgetown University Hospital, Washington, DC, USA.

出版信息

J Community Hosp Intern Med Perspect. 2017 Oct 18;7(5):309-313. doi: 10.1080/20009666.2017.1374108. eCollection 2017.

Abstract

: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. : This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay. We excluded patients with a prior insomnia history. : Out of the 205 patients who met the inclusion criteria, 75 patients (36%) reported insomnia. Severe insomnia was present in 3% of patients. Difficulty in maintaining sleep is the most common symptom. Frequent staff disruptions due to blood draws and vital signs checks were reported by 68% as the cause of insomnia, followed by illness associated causes (64%) and sleep disruption due to noise and or brightness (23%). Patients with insomnia had more awakenings due to noise, brightness, and staff interruptions than those without insomnia (1.35 times vs. 0.9 times,  = 0.027). Patients with respiratory symptoms, cardiac monitoring, oxygen use, private rooms, and no sedative use did not have a higher insomnia risk. Patients with insomnia had significant lower satisfaction scores than patients without insomnia (4.53 vs. 4.05,  = 0.001) but did not have a different length of stay (6.18 vs. 6.19,  = 0.97). In 31% of patients with insomnia who were able to be contacted two weeks after discharge, 75% of them had insomnia resolution. : New onset of insomnia occurred in 36% of hospitalized patients. Most common causes are staff disruption and disease symptoms. It was usually short-term and could decrease patients' satisfaction score.

摘要

失眠在住院患者中很常见。然而,尚无研究调查无失眠病史患者新发失眠的情况。住院患者新发失眠的发生率、相关因素及两周后的缓解率。:这是一项在社区医院进行的前瞻性观察性研究。我们在患者住院第3天至第5天期间,使用失眠严重程度指数问卷对普通内科病房的所有患者进行失眠筛查。我们排除了有失眠病史的患者。:在符合纳入标准的205例患者中,75例(36%)报告有失眠。3%的患者存在严重失眠。维持睡眠困难是最常见的症状。68%的患者报告频繁的采血和生命体征检查导致的医护人员干扰是失眠的原因,其次是疾病相关原因(64%)以及噪音和/或光线导致的睡眠中断(23%)。与无失眠患者相比,失眠患者因噪音、光线和医护人员干扰导致的觉醒次数更多(1.35次对0.9次,P = 0.027)。有呼吸道症状、进行心脏监测、使用氧气、住单人病房且未使用镇静剂的患者失眠风险并未更高。失眠患者的满意度得分显著低于无失眠患者(4.53对4.05,P = 0.001),但住院时间无差异(6.18对6.19,P = 0.97)。在出院两周后能够联系上的失眠患者中,31%的患者有75%的失眠症状得到缓解。:36%的住院患者出现新发失眠。最常见的原因是医护人员干扰和疾病症状。通常为短期,且会降低患者的满意度得分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44db/5676971/244ffeb693fe/ZJCH_A_1374108_F0001_B.jpg

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