阻塞性睡眠呼吸暂停低通气综合征伴脑卒中患者睡眠状况对情绪及日间疲劳的影响

Effect of sleep status on mood and daytime fatigue in patients with obstructive sleep apnea hypopnea syndrome complicating with stroke

  • 摘要:
    目的 研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴脑卒中患者的睡眠状况对焦虑、抑郁情绪及日间疲劳的影响及其相关性。
    方法 纳入2022年5月-2023年2月于郑州大学第二附属医院就诊的脑卒中患者112例, 根据多导睡眠监测(PSG)结果将其分为脑卒中伴OSAHS组(观察组, 54例)及脑卒中组(对照组, 58例)。观察组患者根据睡眠呼吸暂停低通气指数(AHI)分为轻度组(脑卒中伴轻度OSAHS, 15例)和中重度组(脑卒中伴中重度OSAHS, 39例)。入组患者均行PSG, 采用AHI、觉醒指数、深睡眠比例(N3期睡眠占总睡眠时间的比例)、夜间平均血氧饱和度(MSaO2)、夜间最低血氧饱和度(LSaO2)评估患者的睡眠状况; 应用疲劳严重程度量表(FSS)评估患者的日间疲劳状况; 使用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估患者的情绪状况。
    结果 观察组觉醒指数、FSS评分、HAMA评分、HAMD评分高于对照组, 深睡眠比例、MSaO2、LSaO2低于对照组, 差异有统计学意义(P < 0.05); 中重度组觉醒指数、FSS评分、HAMA评分、HAMD评分高于轻度组, 深睡眠比例、MSaO2、LSaO2低于轻度组, 差异有统计学意义(P < 0.05); 观察组AHI与觉醒指数、HAMA评分、HAMD评分、FSS评分呈正相关, 与深睡眠比例、MSaO2、LSaO2呈负相关(P < 0.05); 觉醒指数与HAMA评分、HAMD评分、FSS评分呈正相关(P < 0.05); 深睡眠比例、MSaO2、LSaO2均与HAMA评分、HAMD评分、FSS评分呈负相关(P < 0.05)。
    结论 脑卒中伴OSAHS患者的睡眠状况较单纯脑卒中患者更差, 且睡眠状况与焦虑、抑郁情绪及日间疲劳具有一定相关性。

     

    Abstract:
    Objective To investigate the impacts of sleep status on anxiety, depression, and daytime fatigue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and stroke, and their correlations.
    Methods A total of 112 stroke patients who were admitted to the Second Affiliated Hospital of Zhengzhou University from May 2022 to February 2023 were included, and were divided into stroke with OSAHS group (observation group, 54 cases) and stroke group (control group, 58 cases) according to the results of polysomnography (PSG). The observation group was divided into mild group (15 cases, stroke complicating with mild OSAHS) and moderate to severe group (39 cases, stroke complicating with moderate and severe OSAHS) according to the sleep apnea hypopnea index (AHI). All enrolled patients underwent PSG, and their sleep status was evaluated using AHI, arousal index, ratio of deep sleep (ratio of N3 sleep to total sleep time), nighttime average blood oxygen saturation (MSaO2), and nighttime minimum blood oxygen saturation (LSaO2); the daytime fatigue status of patients was evaluated using the Fatigue Severity Scale (FSS); patients'emotions were evaluated using the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD).
    Results The awakening index, FSS score, HAMA score, and HAMD score of the observation group were higher than those of the control group, while the ratio of deep sleep, MSaO2, and LSaO2 were lower than those of the control group (P < 0.05); the awakening index, FSS score, HAMA score, and HAMD score of the moderate to severe group were higher, while the ratio of deep sleep, MSaO2, and LSaO2 were lower than those in the mild group (P < 0.05). The AHI in the observation group was positively correlated with arousal index, HAMA score, HAMD score, and FSS score (P < 0.05), but negatively correlated with deep sleep proportion, MSaO2, and LSaO2 (P < 0.05); the arousal index was positively correlated with HAMA score, HAMD score, and FSS score (P < 0.05); the ratio of deep sleep, MSaO2, LSaO2 were all negatively correlated with HAMA score, HAMD score, and FSS score (P < 0.05).
    Conclusion The sleep status of stroke patients with OSAHS is worse than that of stroke patients alone, and there are correlations of sleep status with anxiety, depression, and daytime fatigue.

     

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