焦虑和抑郁对失眠风险高的人睡眠质量的影响：一项基于人群的研究。,Frontiers in Neurology

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焦虑和抑郁对失眠风险高的人睡眠质量的影响：一项基于人群的研究。
Frontiers in Neurology ( IF 2.7 ) Pub Date : 2019-08-29 , DOI: 10.3389/fneur.2019.00849
Chang-Myung Oh ₁ , Ha Yan Kim ₂ , Han Kyu Na ₃ , Kyoo Ho Cho ₃ , Min Kyung Chu ₃

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简介：失眠是最常见的睡眠障碍之一，是严重的公共卫生问题。几种精神疾病，例如焦虑症和抑郁症，与失眠有密切关系。然而，这两种情况的结合对失眠严重程度和睡眠质量的临床影响仍然未知。我们调查了失眠风险高的受试者的睡眠障碍与精神病合并症之间的关系。方法：我们分析了2011年11月至2012年1月对19岁至69岁的韩国成年人进行的全国性横断面调查数据。该调查是通过使用结构化问卷进行的面对面访谈进行的。我们使用失眠严重度指数（ISI）来评估失眠，定义的ISI得分≥10的受访者被认为有失眠的高风险。为了诊断焦虑和抑郁，我们分别使用了戈德堡焦虑量表（GAS）和患者健康问卷9（PHQ-9）。结果：在2,762名受访者中，有290名（10.5％）被归类为失眠风险高的受试者；焦虑[赔率（OR），9.8；与没有失眠的参与者相比，该人群更常见[95％置信区间（CI），7.3-13.1]和抑郁症（OR，19.7； 95％CI，13.1-29.6）。在失眠的参与者中，有152名（52.4％）既没有焦虑也没有抑郁，只有63名（21.7％）没有焦虑，有21名（7.2％）只有抑郁，而有54名（18.6％）既有焦虑也有抑郁。与其他组[高ISI，匹兹堡睡眠质量指数（PSQI）和爱华氏嗜睡量表]相比，患有焦虑和抑郁的组在睡眠相关量表上的评分较差。仅当存在焦虑和抑郁时，结局指标（ISI和PSQI）与精神问题之间的关系才有意义。PSQI对精神病合并症和失眠严重程度之间的关系具有重要的调节作用。结论：在失眠的受访者中，精神病合并症可能对白天的警觉性，一般的睡眠质量和失眠的严重程度产生负面影响，尤其是当两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。匹兹堡睡眠质量指数（PSQI）和Epworth嗜睡量表]。仅当存在焦虑和抑郁时，结局指标（ISI和PSQI）与精神疾病之间的关系才有意义。PSQI对精神病合并症和失眠严重程度之间的关系具有重要的调节作用。结论：在失眠的受访者中，精神病合并症可能对白天的警觉性，一般的睡眠质量和失眠的严重程度产生负面影响，尤其是当两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。匹兹堡睡眠质量指数（PSQI）和Epworth嗜睡量表]。仅当存在焦虑和抑郁时，结局指标（ISI和PSQI）与精神疾病之间的关系才有意义。PSQI对精神病合并症和失眠严重程度之间的关系具有重要的调节作用。结论：在失眠的受访者中，精神病合并症可能对白天的警觉性，一般的睡眠质量和失眠的严重程度产生负面影响，尤其是当两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。仅当存在焦虑和抑郁时，结局指标（ISI和PSQI）与精神疾病之间的关系才有意义。PSQI对精神病合并症和失眠严重程度之间的关系具有重要的调节作用。结论：在失眠的受访者中，精神病合并症可能对白天的警觉性，一般的睡眠质量和失眠的严重程度产生负面影响，尤其是当两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。仅当存在焦虑和抑郁时，结局指标（ISI和PSQI）与精神疾病之间的关系才有意义。PSQI对精神病合并症和失眠严重程度之间的关系具有重要的调节作用。结论：在失眠的受访者中，精神病合并症可能对白天的警觉性，一般的睡眠质量和失眠的严重程度产生负面影响，尤其是当两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。和失眠的严重程度，尤其是当两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。和失眠的严重程度，尤其是两种情况同时出现时。因此，临床医生在治疗失眠时应考虑精神病合并症。

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The Effect of Anxiety and Depression on Sleep Quality of Individuals With High Risk for Insomnia: A Population-Based Study.

Introduction: One of the most common sleep disorders, insomnia is a significant public health concern. Several psychiatric disorders, such as anxiety disorders and depression, have shown strong relationships with insomnia. However, the clinical impact of the combination of these two conditions on insomnia severity and sleep quality remains unknown. We investigated the relationship between sleep disturbance and psychiatric comorbidities in subjects with high risk for insomnia. Methods: We analyzed data from a nation-wide cross-sectional survey of Korean adults aged 19 ~ 69 years conducted from November 2011 to January 2012. The survey was performed via face-to-face interviews using a structured questionnaire. We used the insomnia severity index (ISI) to evaluate insomnia and defined respondents with ISI scores of ≥10 were considered to be at high risk for insomnia. To diagnose anxiety and depression, we used the Goldberg anxiety scale (GAS) and Patient Health Questionnaire-9 (PHQ-9), respectively. Results: Of the 2,762 respondents, 290 (10.5%) were classified as subjects with high risk for insomnia; anxiety [odds ratio (OR), 9.8; 95% confidence interval (CI), 7.3-13.1] and depression (OR, 19.7; 95% CI, 13.1-29.6) were more common in this population than in participants without insomnia. Of the participants with insomnia, 152 (52.4%) had neither anxiety nor depression, 63 (21.7%) only had anxiety, 21 (7.2%) only had depression, and 54 (18.6%) had both anxiety and depression. The group with both anxiety and depression was associated with worse scores on sleep-related scales than the other groups [high ISI, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale]. The relationship between outcome measures (ISI and PSQI) and psychiatric problems was significant only when anxiety and depression were present. The PSQI has a significant mediation effect on the relationship between psychiatric comorbidities and insomnia severity. Conclusion: Among the respondents with insomnia, psychiatric comorbidities may have a negative impact on daytime alertness, general sleep quality, and insomnia severity, especially when the two conditions are present at the same time. Clinicians should, therefore, consider psychiatric comorbidities when treating insomnia.

更新日期：2019-11-01

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