Istanbul Physical Medicine Rehabilitation Training and Research Hospital, Istanbul, Turkey.
Int J Rehabil Res. 2020 Dec;43(4):369-375. doi: 10.1097/MRR.0000000000000436.
The aim of the study is to estimate the association between spinal cord injuries related medical factors and subjective sleep disturbance in individuals with short-duration chronic spinal cord injury. Seventy-nine individuals with traumatic spinal cord injuries were included in our study and evaluated using the Beck Depression Index for severity of depressive symptoms, Short-Form Health Survey for quality of life, Douleur Neuropathique 4 score for neuropathic pain severity, and the Pittsburgh Sleep Quality Index for subjective sleep disturbances in a tertiary rehabilitation center. Associated subjective sleep disturbance factors were predicted using multivariate binary logistic regression analysis. Subjective sleep disturbance frequency was 74.7 %, and significantly higher in individuals with paraplegia (P = 0.025, odds ratio, 9.74, 95% confidence interval, 1.21-78.14). Intermittent nighttime catheterization frequency and neuropathic pain severity levels were significantly higher in individuals with subjective sleep disturbance, and quality of life and depressive symptoms were significantly worse in individuals with subjective sleep disturbance. Poor-sleep quality was associated significantly with shorter spinal cord injury duration. The strongest associated factors for sleep disturbance were paraplegic involvement, severity of depressive symptoms (Beck Depression Index score), and quality of life (Short-Form Health Survey general health perceptions score) (odds ratio: 95% confidence interval, 29.75; 1.66-534.36, 1.47; 1.11-1.95, and 0.91; 0.85-0.97, respectively). Our study suggests that paraplegic involvement, low quality of life, and depressive mood are related to sleep disturbance in individuals with traumatic spinal cord injury.
本研究旨在评估与脊髓损伤相关的医学因素与短期慢性脊髓损伤患者主观睡眠障碍之间的关联。我们的研究纳入了 79 名创伤性脊髓损伤患者，并在三级康复中心使用贝克抑郁指数评估抑郁症状严重程度、简明健康调查问卷评估生活质量、疼痛神经病变 4 评分评估神经病理性疼痛严重程度以及匹兹堡睡眠质量指数评估主观睡眠障碍。使用多元二项逻辑回归分析预测与主观睡眠障碍相关的因素。主观睡眠障碍的频率为 74.7%，截瘫患者明显更高（P=0.025，优势比 9.74，95%置信区间 1.21-78.14）。有主观睡眠障碍的患者间歇性夜间导尿频率和神经病理性疼痛严重程度较高，主观睡眠障碍的患者生活质量和抑郁症状明显较差。睡眠质量差与脊髓损伤持续时间较短有显著相关性。睡眠障碍的最强相关因素是截瘫、抑郁症状严重程度（贝克抑郁指数评分）和生活质量（简明健康调查问卷一般健康感知评分）（比值比：95%置信区间，29.75；1.66-534.36，1.47；1.11-1.95，0.91；0.85-0.97）。我们的研究表明，截瘫、生活质量低和抑郁情绪与创伤性脊髓损伤患者的睡眠障碍有关。
