阿尔茨海默病患者睡眠障碍的临床特点及相关因素

doi:10.6040/j.issn.1673-3770.0.2014.236

摘要/Abstract

摘要： 目的分析阿尔茨海默病(AD)患者睡眠障碍的临床特点, 探讨其与认知、精神行为、生活能力及护理负担的关系。方法收集山东省立医院神经内科就诊的阿尔茨海默病33例患者病历资料, 采用简易精神状态评价量表(MMSE)等评估认知功能、精神症状和生活能力, 采用匹斯堡睡眠质量指数(PSQI)和艾泼沃兹嗜睡量表(ESS)进行评估, 将各量表得分进行相关分析。根据PSQI得分将患者分组, 比较有无睡眠障碍的两组患者各量表得分情况。结果 PSQI量表中各类型的睡眠障碍在AD患者中均有发生, 发生率最高的依次为睡眠干扰(57.6%)、睡眠效率减低(54.5%)、日间功能障碍(51.5%)。PSQI得分与MMSE得分呈负相关, 与CDR得分呈正相关。AD患者睡眠质量、入睡困难、睡眠时间、睡眠效率得分与MMSE得分呈负相关。定向力、即刻记忆、绘图等与PSQI得分呈负相关。AD患者中有睡眠障碍的较无睡眠障碍的CDR得分高, MMSE得分低。精神症状中, 妄想、情感淡漠、食欲/进食障碍与睡眠障碍有相关性。有睡眠障碍的日常生活能力量表、护理负担量表得分高于无睡眠障碍患者。结论 AD患者普遍出现各种类型的睡眠障碍, 此类患者的睡眠障碍与其痴呆程度、认知功能、日常生活能力、精神症状等密切相关, 相对应的护理负担加重。

关键词: 艾泼沃兹日间嗜睡量表, 阿尔茨海默病, 匹斯堡睡眠质量指数, 睡眠障碍, 日间嗜睡

Abstract: Objective To describe the characteristic of sleep disorders in patients with Alzheimer's disease and discuss the relationships between sleep disorder and cognitive function, psychiatric symptoms, living abilities and the caregiver burden. Methods 33 patients with Alzheimer's disease were recruited from clinics of Shandong Provincial Hospital. MMSE was used to measure the cognitive function and the degree of dementia. PSQI and ESS were used to evaluate the sleep disorders of the patients. The data were analyzed with software SPSS version 21.0. Results All items in PSQI occured in AD patients. The most common symptoms were sleep disturbance (57.6%), followed by reduction of sleep efficiency (54.5%) and daytime dysfunction (51.5%), most of which were of mild impairment. The least common item is the using of hypnotic drugs (9.1%). In PSQI, the sleep quality, difficulty falling asleep, sleep time, sleep efficiency were negatively related to MMSE score. In MMSE, orientation, immediate memory, drawing were negatively related to PSQI score. NPI and CSDD scores were both possitively related to PSQI score. Delusion, apathy, sleep/behavior at night and depression were more related to sleep disorders. Patients with sleep disorders had higher ADL and ZBI scores than patients without sleep disorder. Conclusion Various kinds of sleep disorders can occur in the process of Alzheimer's disease. The sleep disorders are closely related to the degree of dementia, cognitive function, living ability and psychiatric symptoms. Also, sleep disorders aggravate the patients' caregiver burden.

Key words: Daytime sleepiness, Epworth sleepiness scale, Sleep disorder, Pittsburgh sleep quality index, Alzheimer's disease

中图分类号:

R741

何迎雪, 丛琳, 杜怡峰. 阿尔茨海默病患者睡眠障碍的临床特点及相关因素[J]. 山东大学耳鼻喉眼学报, 2015, 29(2): 1-8.

HE Ying-xue, CONG Lin, DU Yi-feng. Clinical investigation of sleep disorders and related factors in Alzheimer's disease[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(2): 1-8.

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