The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (mainland).
School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2022 Jul 28;28:e937134. doi: 10.12659/MSM.937134.
BACKGROUND Factors affecting subjective perception of sleep are unclear but clinically important. We investigated the differences in subjective sleep perception of patients with obstructive sleep apnea (OSA) and insomnia disorder (ID). MATERIAL AND METHODS From our Sleep Medicine Center database, 33 patients with OSA and 69 with ID were selected and assessed with the Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder screen, Patient Health Questionnaire-9, Epworth Sleepiness Scale, Pre-sleep Arousal Scale (PSAS), and polysomnography. RESULTS In subjective sleep tests, PSQI total score, sleep quality, sleep onset latency (SOL), total sleep time, and sleep efficiency (SE) were higher in patients with ID. In objective sleep tests, patients with OSA had longer total sleep time, shorter SOL, lower percentage of stage N3, less SE, higher percentage of stage N1, more arousals, and higher arousal index. Hyperarousal state evaluation showed cognitive hyperarousal significantly higher with ID. Subjective sleep perception with OSA correlated positively with PSAS total score, cognitive hyperarousal, and percentage of stage N2 and negatively with percentage of REM, apnea-hypopnea index, and desaturation index. Subjective sleep perception of patients with ID correlated positively with PSAS total score, cognitive hyperarousal, SOL, N3 sleep latency, and REM sleep latency and negatively with SE. CONCLUSIONS Subjective sleep perception of OSA patients was mainly related to sleep structure and respiratory events, and that of ID patients, to sleep latency. Individual cognitive hyperarousal levels may be involved in negative subjective sleep perception. Clinicians should be aware that OSA patients may not actually experience adequate sleep.
影响主观睡眠感知的因素尚不清楚，但具有重要的临床意义。我们研究了阻塞性睡眠呼吸暂停（OSA）和失眠障碍（ID）患者主观睡眠感知的差异。
我们从睡眠医学中心的数据库中选择了 33 名 OSA 患者和 69 名 ID 患者，并使用匹兹堡睡眠质量指数（PSQI）、广泛性焦虑障碍筛查、患者健康问卷-9、Epworth 嗜睡量表、睡前觉醒量表（PSAS）和多导睡眠图进行评估。
在主观睡眠测试中，ID 患者的 PSQI 总分、睡眠质量、入睡潜伏期（SOL）、总睡眠时间和睡眠效率（SE）较高。在客观睡眠测试中，OSA 患者的总睡眠时间更长，SOL 更短，N3 期比例更低，SE 更低，N1 期比例更高，觉醒更多，觉醒指数更高。认知性过度觉醒评估显示 ID 患者的认知性过度觉醒明显更高。OSA 患者的主观睡眠感知与 PSAS 总分、认知性过度觉醒和 N2 期比例呈正相关，与 REM 期比例、呼吸暂停-低通气指数和低氧饱和度指数呈负相关。ID 患者的主观睡眠感知与 PSAS 总分、认知性过度觉醒、SOL、N3 睡眠时间和 REM 睡眠时间呈正相关，与 SE 呈负相关。
OSA 患者的主观睡眠感知主要与睡眠结构和呼吸事件有关，而 ID 患者的主观睡眠感知主要与睡眠潜伏期有关。个体的认知性过度觉醒水平可能与负面的主观睡眠感知有关。临床医生应该意识到，OSA 患者可能实际上并没有获得足够的睡眠。
