West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Operation Unit, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Wuhou District, Chengdu, Sichuan Province, China.
Clin Rheumatol. 2018 Aug;37(8):2161-2168. doi: 10.1007/s10067-018-4190-3. Epub 2018 Jul 3.
Sleep disturbance is prevalent among patients with ankylosing spondylitis (AS) and is considered a multifactorial issue. The study was designed to investigate sleep disturbance and its associated factors in AS outpatients in Southwest China. Patients were recruited by convenience sampling in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI), the Bath AS Patient Global Score (BAS-G), and the Hospital Anxiety and Depression Scale (HADS) were used to assess sleep quality, disease activity, function status, global well-being, depression, and anxiety. Spearman's correlation, t test, ANOVA, and multiple linear regression analysis were used to explore the associated factors of sleep disturbance. Of the 281 outpatients included in the study, 190 (67.6%) patients had sleep disturbance. The married patients, the patients with extra-spinal manifestation, depression and anxiety, longer duration of diagnostic delay, higher disease activity, worse functional status and global well-being, high level of pain, and fatigue, had poorer sleep quality (P < 0.05). Multiple linear regression analysis revealed age (β = 0.087, P = 0.102), BAS-G (β = 0.181, P = 0.003), fatigue (β = 0.170, P = 0.002), anxiety (β = 0.151, P = 0.002) and nocturnal back pain (β = 0.192, P = 0.001), extra-spinal manifestation (β = 0.120, P = 0.012), and duration of diagnostic delay (β = 0.174, P = 0.001) were the contributors to PSQI. Sleep disturbance is common in AS patients in Southwest China. It may be useful to keep regular exercise, strengthen the management of pain, relieve anxiety, and prevent and treat extra-spinal manifestation for improving sleep quality.
睡眠障碍在强直性脊柱炎（AS）患者中很常见，被认为是一个多因素问题。本研究旨在调查中国西南地区 AS 门诊患者的睡眠障碍及其相关因素。本横断面研究采用便利抽样法招募患者。采用匹兹堡睡眠质量指数（PSQI）、 Bath AS 疾病活动指数（BASDAI）、 Bath AS 功能指数（BASFI）、 Bath AS 患者总体评分（BAS-G）和医院焦虑抑郁量表（HADS）评估睡眠质量、疾病活动、功能状态、总体健康状况、抑郁和焦虑。采用 Spearman 相关分析、t 检验、方差分析和多元线性回归分析探讨睡眠障碍的相关因素。本研究共纳入 281 例门诊患者，其中 190 例（67.6%）患者存在睡眠障碍。婚姻状况、有脊柱外表现、抑郁和焦虑、诊断延迟时间较长、疾病活动度较高、功能状态和总体健康状况较差、疼痛和疲劳程度较高的患者睡眠质量较差（P<0.05）。多元线性回归分析显示年龄（β=0.087，P=0.102）、BAS-G（β=0.181，P=0.003）、疲劳（β=0.170，P=0.002）、焦虑（β=0.151，P=0.002）和夜间背痛（β=0.192，P=0.001）、脊柱外表现（β=0.120，P=0.012）和诊断延迟时间（β=0.174，P=0.001）是 PSQI 的影响因素。中国西南地区 AS 患者睡眠障碍较为常见。保持规律运动、加强疼痛管理、缓解焦虑、预防和治疗脊柱外表现可能有助于改善睡眠质量。
