Mysliwiec Vincent, Brock Matthew S, Pruiksma Kristi E, Straud Casey L, Taylor Daniel J, Hansen Shana, Foster Shannon N, Mithani Sara, Zwetzig Sarah, Gerwell Kelsi, Young-McCaughan Stacey, Powell Tyler, Blue Star John A, Cassidy Daniel G, Mintz Jim, Peterson Alan L
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, TX, USA.
Sleep. 2022 Dec 12;45(12). doi: 10.1093/sleep/zsac203.
The aim of this study was to characterize the sleep disorders of insomnia, obstructive sleep apnea (OSA), and comorbid insomnia and OSA (COMISA) in active duty military personnel.
Prospective observational study of 309 military personnel with a mean age of 37.17 years (SD = 7.27). Participants served in four branches of the U.S. military (47.9% Air Force, 38.8% Army, 11.3% Navy, and 1.9% Marines). Sleep diagnoses were rendered after video-polysomnography and a clinical evaluation. Validated self-report measures assessed insomnia severity, excessive daytime sleepiness, sleep quality, disruptive nocturnal behaviors, nightmare disorder, shift work disorder (SWD), sleep impairment, fatigue, posttraumatic stress disorder (PTSD) symptoms, anxiety, depression, and traumatic brain injury (TBI). General linear models and Pearson chi-square tests were used for between-group differences in data analyses.
Insomnia was diagnosed in 32.7%, OSA in 30.4% and COMISA in 36.9%. Compared to military personnel with OSA alone, those with insomnia only and COMISA had significantly greater insomnia severity, disruptive nocturnal behaviors, sleep-related impairment, rates of nightmare disorder, and poorer sleep quality (all Ps < .05). They also reported greater symptoms of fatigue, PTSD, anxiety, and depression (all Ps < .05). There were no significant differences among the three sleep disorder diagnostic groups on sleepiness, SWD, or TBI.
Military personnel with insomnia only and COMISA overall report worsened symptoms of sleep disorders, sleep-related impairment, fatigue, and psychiatric disorders than those with OSA. Results highlight the importance of a comprehensive assessment for sleep-related impairment, sleep, and comorbid disorders in military personnel with clinically significant sleep disturbances.
本研究旨在描述现役军人中失眠、阻塞性睡眠呼吸暂停（OSA）以及失眠合并OSA（COMISA）的睡眠障碍特征。
对309名平均年龄为37.17岁（标准差 = 7.27）的军人进行前瞻性观察研究。参与者服役于美国军队的四个军种（空军占47.9%，陆军占38.8%，海军占11.3%，海军陆战队占1.9%）。在进行视频多导睡眠图检查和临床评估后做出睡眠诊断。通过经过验证的自我报告量表评估失眠严重程度、日间过度嗜睡、睡眠质量、夜间干扰行为、噩梦障碍、倒班工作障碍（SWD）、睡眠损害、疲劳、创伤后应激障碍（PTSD）症状、焦虑、抑郁以及创伤性脑损伤（TBI）。在数据分析中使用一般线性模型和Pearson卡方检验来比较组间差异。
诊断出失眠的占32.7%，OSA的占30.4%，COMISA的占36.9%。与仅患有OSA的军人相比，仅患有失眠和患有COMISA的军人在失眠严重程度、夜间干扰行为、与睡眠相关的损害、噩梦障碍发生率以及睡眠质量方面显著更高（所有P值 <.05）。他们还报告有更严重的疲劳、PTSD、焦虑和抑郁症状（所有P值 <.05）。在三个睡眠障碍诊断组之间，在嗜睡、SWD或TBI方面没有显著差异。
仅患有失眠和患有COMISA的军人总体上报告的睡眠障碍、与睡眠相关的损害、疲劳和精神障碍症状比患有OSA的军人更严重。结果凸显了对有临床显著睡眠障碍的军人进行与睡眠相关损害、睡眠及共病的综合评估的重要性。
