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门诊记忆诊所中认知功能减退患者照料者的失眠症状

Insomnia symptoms among caregivers of persons with cognitive decline in an outpatient memory clinic.

作者信息

Gallagher Virginia, Mattos Meghan, Patterson Ashleigh, Thompson Ryan C, Reilly Shannon, Shaffer Kelly, Manning Carol

机构信息

Department of Neurology, School of Medicine, University of Virginia, PO Box 801018, Charlottesville, VA, 22908, USA.

PO Box 800782, School of Nursing, University of Virginia, USA.

出版信息

Sleep Med. 2024 Dec;124:38-41. doi: 10.1016/j.sleep.2024.09.009. Epub 2024 Sep 8.

Abstract

BACKGROUND

Significant insomnia symptoms can have important impacts on the health and quality of life of caregivers of persons with cognitive decline (PwCD).

OBJECTIVE

To characterize the prevalence of clinically significant insomnia symptoms using the recommended community cutoff for the Insomnia Severity Index (ISI; ≥10) and identify correlates of the presence of symptoms.

METHODS

Eighty PwCD caregivers were recruited from a memory and aging care clinic in an academic medical center and completed all study procedures (M = 66.05 ± 13.45 years; 93.75 % non-Hispanic White, 71.00 % spouses, 81.25 % co-dwelling with PwCD). Caregivers completed the ISI, Hospital Anxiety and Depression Scale, and Zarit Burden Interview (12-item).

RESULTS

One-third of PwCD caregivers reported clinically significant insomnia symptoms. Caregivers reporting these symptoms were more likely to report difficulty sleeping due to stressful/anxious thoughts about the PwCD compared to caregivers without insomnia symptoms (p < .001). No group differences were detected between caregivers with and without insomnia symptoms based on reported frequency of PwCD nighttime care needs or behaviors. Caregivers with insomnia symptoms endorsed significantly higher depression symptoms, anxiety symptoms, and caregiving psychological burden (ps < 0.001).

CONCLUSIONS

PwCD stress and psychological burden, but not PwCD nighttime factors, appear to be associated with clinically significant insomnia symptoms among PwCD caregivers. Existing evidenced-based treatments for insomnia, such as cognitive behavioral therapy for insomnia, may be effective in this cohort.

摘要

背景

严重的失眠症状会对认知功能减退患者(PwCD)的照护者的健康和生活质量产生重要影响。

目的

使用失眠严重程度指数(ISI;≥10)推荐的社区临界值来描述具有临床意义的失眠症状的患病率,并确定症状存在的相关因素。

方法

从一家学术医疗中心的记忆与衰老护理诊所招募了80名PwCD照护者,并完成了所有研究程序(M = 66.05 ± 13.45岁;93.75%为非西班牙裔白人,71.00%为配偶,81.25%与PwCD共同居住)。照护者完成了ISI、医院焦虑抑郁量表和Zarit负担访谈(12项)。

结果

三分之一的PwCD照护者报告有具有临床意义的失眠症状。与没有失眠症状的照护者相比,报告这些症状的照护者更有可能报告由于对PwCD的压力/焦虑想法而难以入睡(p <.001)。根据报告的PwCD夜间护理需求或行为的频率,有失眠症状和无失眠症状的照护者之间未发现组间差异。有失眠症状的照护者认可的抑郁症状、焦虑症状和照护心理负担明显更高(p < 0.001)。

结论

PwCD的压力和心理负担,而非PwCD的夜间因素,似乎与PwCD照护者中具有临床意义的失眠症状相关。现有的基于证据的失眠治疗方法,如失眠认知行为疗法,可能对该队列有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5a/11663100/8d08c97f1413/nihms-2022771-f0001.jpg

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