Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Department of Cardiology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Transl Psychiatry. 2019 Jul 22;9(1):175. doi: 10.1038/s41398-019-0510-x.
Sleep disturbances and psychiatric repercussions pose great challenges at high altitude; however, few studies have investigated sleep disturbance and anxiety profiles and their associations after acute exposure in consecutive patients. Thus, we aimed to study the profiles of sleep disturbances in consecutive patients after high-altitude exposure and the association of such disturbances with anxiety. A total of 668 participants were recruited at sea level and 3700 m. The trials were performed at sea level (1 week prior to a 2-h flight to a high-altitude destination) and at 3700 m (24, 72, and 168 h). Sleep disturbances were assessed by self-reported sleep patterns and scores on the Athens Insomnia Scale (AIS). State anxiety was assessed using the Self-Rating Anxiety Scale (SAS). In our study, the incidence of sleep disturbances increased significantly after acute high-altitude exposure (65.3%, 434/668) and then gradually decreased after 72 h (50%, 141/282) and 168 h (44%, 124/282). The sleep assessments AIS [2.0 (4.0) vs. 4.0 (5.0)] and ESS [4.0 (4.0) vs. 5.0 (5.0)] increased significantly (p < 0.05). Also, the SAS increased significantly from 26.25 (3.75) to 28.75 (7.5). The SAS was significantly high in sleep disturbance group [31.25 (7.5) vs. 27.5 (5), p < 0.001] than in the non-sleep- disturbance group. The baseline SAS and AIS scores were significantly higher in participants with sleep disturbances than in those without (p < 0.01). Age, baseline insomnia, sleepiness, fatigue, and higher SAS were predictors of sleep disturbances in univariate regression (all p values < 0.05). However, only an older age (p = 0.045) and a higher baseline SAS (p = 0.018) remained independent predictors of sleep disturbances. Our findings indicated that acute high-altitude exposure triggers the onset of sleep disturbances, which are closely associated with anxiety. Furthermore, baseline state anxiety and age are independent predictors of sleep disturbances at high altitude.
睡眠障碍和精神方面的影响在高海拔地区是巨大的挑战；然而，很少有研究调查急性暴露后连续患者的睡眠障碍和焦虑特征及其相关性。因此，我们旨在研究高海拔暴露后连续患者的睡眠障碍特征，以及这些障碍与焦虑的关系。共有 668 名参与者在海平面和 3700 米处接受了招募。试验分别在海平面（飞行到高海拔目的地前的 2 小时内进行了 1 周）和 3700 米处（24、72 和 168 小时）进行。睡眠障碍通过自我报告的睡眠模式和雅典失眠量表（AIS）评分进行评估。状态焦虑使用自评焦虑量表（SAS）进行评估。在我们的研究中，急性高原暴露后睡眠障碍的发生率显著增加（65.3%，434/668），然后在 72 小时（50%，141/282）和 168 小时（44%，124/282）逐渐减少。AIS [2.0（4.0）比 4.0（5.0）]和 ESS [4.0（4.0）比 5.0（5.0）]的睡眠评估显著增加（p<0.05）。此外，SAS 从 26.25（3.75）显著增加到 28.75（7.5）。睡眠障碍组的 SAS 显著升高[31.25（7.5）比 27.5（5），p<0.001]，而非睡眠障碍组。有睡眠障碍的参与者的基线 SAS 和 AIS 评分明显高于没有睡眠障碍的参与者（p<0.01）。年龄、基线失眠、嗜睡、疲劳和较高的 SAS 是单变量回归中睡眠障碍的预测因素（所有 p 值均<0.05）。然而，只有年龄较大（p=0.045）和基线 SAS 较高（p=0.018）仍然是高原睡眠障碍的独立预测因素。我们的研究结果表明，急性高原暴露引发了睡眠障碍的发作，而睡眠障碍与焦虑密切相关。此外，基线状态焦虑和年龄是高原睡眠障碍的独立预测因素。
