阻塞性睡眠呼吸暂停低通气综合征患者抑郁状况及相关因素研究
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摘要
目的:调查阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的抑郁状况及其影响因素。
方法:采用描述性研究方法,对2008年1月至11月在湘雅二医院睡眠实验室经多导睡眠图确诊的114例OSAHS患者进行调查。主要研究工具包括自编的一般情况调查表、Epworth嗜睡量表,(ESS)、匹兹堡睡眠质量指数(PSQI)、贝克抑郁量表(BDI)、Calgary生活质量指数和简易应对方式问卷。所收集资料采用Excel建立数据库,采用SPSS13.0软件进行统计分析。统计方法包括描述性统计分析、t检验、单因素方差分析、非参数Kruskal-Wallis H检验、Pearson相关分析、多元线性逐步回归分析。
结果:1.OSAHS患者的BDI得分平均为(8.29±6.46)分。伴抑郁的患者37例(32.5%)。轻度抑郁27例(23.7%)、中度抑郁9例(7.9%)、重度抑郁1例(0.9%)。
2.ESS、AHI、LSaO_2、MSaO_2与抑郁得分均无显著相关。PSQI总分及主观睡眠质量、睡眠时间、睡眠效率、睡眠紊乱、使用催眠药物、日间功能障碍与抑郁呈显著正相关。
3.抑郁组患者的SAQLI总分及日常活动、社会交往、情感功能和症状四个维度得分均低于无抑郁组,差异有统计学意义。且SAQLI总分及日常活动、社会交往、情感功能、症状4个维度与抑郁呈显著负相关。
4.无抑郁患者的积极应对方式与常模比较,差异无统计学意义;而消极应对方式得分低于常模,差异有统计学意义。抑郁患者的积极应对方式和消极应对方式与常模比较,差异均有统计学意义。OSAHS患者的消极应对方式与抑郁成正相关;积极应对方式与抑郁无显著相关。
结论:1.约1/3的OSAHS患者伴有抑郁症状;OSAHS患者以轻度抑郁为主,而中重度抑郁较少。2.PSQI总分、主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠紊乱、使用催眠药物、日间功能障碍、积极应对方式、消极应对方式对患者的抑郁状况有影响。其中PSQI总分、消极应对方式、积极应对方式、使用催眠药物、入睡时间是患者抑郁状况的主要影响因素。
Objective: To investigate the depression and its influencing factors in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).
Methods: This study is using a descriptive research design. The scales of the the demographic data, Epworth SsleepinessScale(ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), The Calgary Sleep Apnea Quality of Life Index(SAQLI), Simplified Coping Style Questionnaire(SCSQ) were tested in 114 patients with OSAHS. Descriptive analysis, T-test, completely randomized design analysis of variance, Kruskal-Wallis H, Pearson correlation analysis and multiple linear stepwise regression were performed by SPSS 13.0.
Results : 1. The average BDI score was (8.29±6.46). 32.5% of them had depression. 27 patients with mild depression (23.7%), 9 patients with moderate depression (7.9%), one patients with severe depression (0.9%). 2. There were no correlations between the ESS, AHI, LSaO_2, MSaO_2 and depression. There were positively correlations between the PSQI total score, the subjective sleep quality, sleep time, sleep efficiency, sleep disturbance, using hypnotic drugs, day-time dysfunction and depression. 3. There was a significant difference of the SAQLI total scores, daily functioning, social interactions, emotional functioning and symptoms between depression and non depression groups. There were negative correlations between the SAQLI total scores, daily functionin, social interaction, emotional function, symptoms and depression in patients with OSAHS. 4. There was a significant difference of negative coping style between depression and non-depression group in patients with OSAHS. There were positively correlations between negative coping style and depression. There were no correlations between active coping style and depression.
Conclusion: 1. About 1 / 3 of the patients with OSAHS has depressive symptoms; Most of the patients of OSAHS were mild depressed range, few of them in the moderate to severe depressed range. 2.PSQI score, negative coping style, positive coping style, using hypnotic drugs and time for falling asleep were influential factors in patients with OSAHS.
方法:采用描述性研究方法,对2008年1月至11月在湘雅二医院睡眠实验室经多导睡眠图确诊的114例OSAHS患者进行调查。主要研究工具包括自编的一般情况调查表、Epworth嗜睡量表,(ESS)、匹兹堡睡眠质量指数(PSQI)、贝克抑郁量表(BDI)、Calgary生活质量指数和简易应对方式问卷。所收集资料采用Excel建立数据库,采用SPSS13.0软件进行统计分析。统计方法包括描述性统计分析、t检验、单因素方差分析、非参数Kruskal-Wallis H检验、Pearson相关分析、多元线性逐步回归分析。
结果:1.OSAHS患者的BDI得分平均为(8.29±6.46)分。伴抑郁的患者37例(32.5%)。轻度抑郁27例(23.7%)、中度抑郁9例(7.9%)、重度抑郁1例(0.9%)。
2.ESS、AHI、LSaO_2、MSaO_2与抑郁得分均无显著相关。PSQI总分及主观睡眠质量、睡眠时间、睡眠效率、睡眠紊乱、使用催眠药物、日间功能障碍与抑郁呈显著正相关。
3.抑郁组患者的SAQLI总分及日常活动、社会交往、情感功能和症状四个维度得分均低于无抑郁组,差异有统计学意义。且SAQLI总分及日常活动、社会交往、情感功能、症状4个维度与抑郁呈显著负相关。
4.无抑郁患者的积极应对方式与常模比较,差异无统计学意义;而消极应对方式得分低于常模,差异有统计学意义。抑郁患者的积极应对方式和消极应对方式与常模比较,差异均有统计学意义。OSAHS患者的消极应对方式与抑郁成正相关;积极应对方式与抑郁无显著相关。
结论:1.约1/3的OSAHS患者伴有抑郁症状;OSAHS患者以轻度抑郁为主,而中重度抑郁较少。2.PSQI总分、主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠紊乱、使用催眠药物、日间功能障碍、积极应对方式、消极应对方式对患者的抑郁状况有影响。其中PSQI总分、消极应对方式、积极应对方式、使用催眠药物、入睡时间是患者抑郁状况的主要影响因素。
Objective: To investigate the depression and its influencing factors in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).
Methods: This study is using a descriptive research design. The scales of the the demographic data, Epworth SsleepinessScale(ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), The Calgary Sleep Apnea Quality of Life Index(SAQLI), Simplified Coping Style Questionnaire(SCSQ) were tested in 114 patients with OSAHS. Descriptive analysis, T-test, completely randomized design analysis of variance, Kruskal-Wallis H, Pearson correlation analysis and multiple linear stepwise regression were performed by SPSS 13.0.
Results : 1. The average BDI score was (8.29±6.46). 32.5% of them had depression. 27 patients with mild depression (23.7%), 9 patients with moderate depression (7.9%), one patients with severe depression (0.9%). 2. There were no correlations between the ESS, AHI, LSaO_2, MSaO_2 and depression. There were positively correlations between the PSQI total score, the subjective sleep quality, sleep time, sleep efficiency, sleep disturbance, using hypnotic drugs, day-time dysfunction and depression. 3. There was a significant difference of the SAQLI total scores, daily functioning, social interactions, emotional functioning and symptoms between depression and non depression groups. There were negative correlations between the SAQLI total scores, daily functionin, social interaction, emotional function, symptoms and depression in patients with OSAHS. 4. There was a significant difference of negative coping style between depression and non-depression group in patients with OSAHS. There were positively correlations between negative coping style and depression. There were no correlations between active coping style and depression.
Conclusion: 1. About 1 / 3 of the patients with OSAHS has depressive symptoms; Most of the patients of OSAHS were mild depressed range, few of them in the moderate to severe depressed range. 2.PSQI score, negative coping style, positive coping style, using hypnotic drugs and time for falling asleep were influential factors in patients with OSAHS.
引文
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[5]曾梅,陈晓军,陈飞鹏.阻塞性睡眠呼吸暂停综合征的情绪状况[J].现代临床医学生物工程学杂志,2002,8(2):99-100.
[6]倪明,岳伟华,刘破资.睡眠呼吸暂停低通气综合征患者的抑郁焦虑症状研究[J].中国临床心理学杂志,200412(2):192-193.
[7]邝锦辉,陈晓军,田利奇,等.阻塞性睡眠呼吸暂停综合征患者情绪障碍的因素分析[J].广西医学,2005,27(5):639-640.
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