ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To evaluate the effectiveness ofradiofrequency volumetric tissue reduction （RFVTR） in the treatment of sleep disordered breathing （SDB ）. Methods We searched The Cochrane Central Register of Controlled Trials （Issue 1, 2005）, MEDLINE （1966 to Apr. 2005）, EMBASE （1989 to Apr. 2005）, CINAHL （1982 to Dec. 2000）, VIP （1989 to Dec. 2004） , CJFD （1979 to 2005）, WANFANG DATA （1977 to 2004） , and CBMdisc （1978 to 2005）. The bibliographies of all papers retrieved in full text form and relevant narrative reviews were searched for additional publications. All randomized controlled clinical trials （RCT） or quasi-randomized controlled trials （quasi-RCT） or prospective cohort studies of RFVTR alone or in combination with other treatments compared with placebo or other treatments were included. Data were extracted independently from the trial reports by the two authors. Meta-analysis was performed using RevMan software. Results There were 11 studies including 540 patients met the inclusion criteria for this review, among which five were RCTs, six were prospective cohort studies, and all trials were of lower methodological quality. RFVTR showed benefit over placebo in apnea index （AI）, but this benefit was not seen in other polysorrmography （PSG） parameters, symptom and quality of life, psychomotor vigilance pain, swallowing difficulty and adverse events. Compared with continuous positive airway pressure （CPAP）, uvulopalatopharyngoplasty （UPPP） and laser assisted uvulopalatoplasty （LAUP） , RFVTR was more effective in psychomotor vigilance pain and swallowing difficulty, but this effect was not seen in PSG parameters, symptom and quality of life. Conclusions RFVTR is more effective than placebo in AI improvement and other treatments in decreasing postoperative pain and other adverse events ; but this benefit was not seen in improving quality of sleeping and life. More well-designed randomized trials need to be conducted to identify the effectiveness and the influence on effectiveness of severity and frequency of treatment.
Objective To explore the influencing factors of sleep quality of the elderly in Chengdu community and put forward corresponding nursing strategies. Methods The elderly in four communities in Chengdu were selected by convenient sampling method from January to June 2021. The elderly in the community were investigated and analyzed by general information questionnaire, Interpersonal Relationship Integrative Diagnostic Scale (IRIDS) and Pittsburgh Sleep Quality Index (PSQI). Multiple linear stepwise regression was used to analyze the factors affecting the sleep quality of the elderly. Results A total of 232 elderly were investigated and 211 were finally included. The total score of PSQI in the elderly was positively correlated with the score of interpersonal conversation disturbance (r=0.297, P<0.05) and the score of treating people disturbance (r=0.208, P<0.05). The results of multiple linear stepwise regression analysis showed that physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were the main influencing factors of sleep quality in the elderly. Conclusions The community elderly in this study had better sleep quality. Physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were all important factors affecting the sleep quality of the elderly. Community nursing staff should pay more attention to the sleep quality of the elderly, put forward measures to improve the related factors leading to sleep disorders, encourage the elderly to take physical exercise. They should also provide psychological counseling and interpersonal communication skills for the elderly with interpersonal troubles and help expand the communication platform to improve sleep quality of the elderly in the community.
ObjectiveTo observe the correlation between obstructive sleep apnea syndrome (OSAS) and central serous chorioretinopathy (CSC).MethodsFrom October 2016 to December 2018, 50 cases of CSC patients (CSC group) and 50 healthy people (control group) matched by age and sex who were diagnosed in the ophthalmological examination of Xi’an No.3 Hospital were included in the study. According to the course of the disease, CSC was divided into acute phase and chronic phase, with 20 and 30 cases respectively. The average age (Z=1.125) and body mass index (BMI) (Z=0.937) of the two groups were compared, and the difference was not statistically significant (P＞0.05); the age of patients with different courses of CSC (Z=1.525) and gender composition ratio (χ2=0.397) and BMI (Z=1.781) were compared, the difference was not statistically significant (P＞0.05). The Berlin questionnaire was used to assess the OSAS risk of subjects in the CSC group and the control group; polysomnography was used to monitor the apnea-hypopnea index (AHI) and minimum blood oxygen saturation (MOS) during night sleep. OSAS diagnostic criteria: typical sleep snoring, daytime sleepiness, AHI (times/h) value ≥ 5. The severity of OSAS was classified as mild OSAS: 5≤AHI＜15; moderate OSAS: 15≤AHI＜30; severe OSAS: AHI≥30. Non-normally distributed measurement data were compared by rank sum test; count data were compared by χ2 test. Spearman correlation analysis was performed on the correlation between OSAS and CSC.ResultsThe AHI data in the CSC group and the control group were 17.46±3.18 and 15.72±4.48 times/h, respectively; the MOS were (83.48±4.68)% and (87.40±3.82)%, respectively; those diagnosed with OSAS were respectively 36 (72.00%, 36/50) and 13 (26.00%, 13/50) cases. AHI (Z=0.312), MOS (Z=0.145), and OSAS incidence (χ2=21.17) were compared between the two groups of subjects, and the differences were statistically significant (P=0.028, 0.001,＜0.001). The AHI of acute and chronic CSC patients were 15.95±3.02 and 18.47±2.92 times/h; the MOS were (86.10±11.07)% and (81.73±4.58)%, respectively. There were statistically significant differences in AHI (Z=0.134) and MOS (Z=0.112) in patients with different course of disease (P=0.005, 0.001). The results of Spearman correlation analysis showed that OSAS and CSC were positively correlated (r=0.312, P=0.031).ConclusionOSAS may be a risk factor for the onset of CSC.
Objective To investigate the mediating effect of nursing intervention of sleep hygiene on insomnia in patients with liver cirrhosis. Methods One hundred and eighteen cirrhotic patients with grade-A liver function and insomnia treated between June 2012 and January 2015 were divided into control group (n=52) and intervention group (n=66) with random number table method. The control group received conventional nursing only, while the intervention group was given nursing intervention of sleep hygiene. The sleep quality of patients in the two groups on admission and discharge were surveyed and compared based on Pittsburgh sleep quality index (PSQI). The nursing effect was also compared between the two groups on discharge. Results There was no statistically significant difference in total score and scores for each factor of PSQI between the two groups of patients on admission (P>0.05). However, the total score and scores for each factor of PSQI on discharge in both groups were significantly lower than those on admission (P<0.05). Besides, the scores in the intervention group were significantly lower than those in the control group (P<0.05). The effect of nursing in the intervention group was superior to that in the control group (P<0.001). Conclusions Nursing intervention of sleep hygiene can effectively improve sleep quality in cirrhotic patients with grade-A liver function. The role of nursing intervention in the treatment of insomnia should be taken seriously.
Objective To investigate the relative factors of sleep disorders in patients after arthroscopic knee surgery.MethodsThe clinical data of 155 patients undergoing arthroscopic knee surgery in West China Hospital of Sichuan University from October 1st 2017 to April 1st 2018 were analyzed. The sleep quality index was assessed by the Pittsburgh Sleep Quality Index. According to the scores, the patients were divided into two groups: the sleep disorder group and the non-sleep disorder group. Mindfulness level were evaluated by Mindful Attention Awareness Scale (MAAS). The binary logistic regression was used to assess the relationship between MAAS and sleep disorders.ResultsAmong the enrolled cases, there were 135 males and 20 females, with an average age of (34.12±12.13) years; 64 patients had poor sleep quality. The results of univariate analysis showed that the payment method, single or bilateral lesions, and MAAS score were the factors affecting sleep (P<0.05). The results of multivariate analysis indicated that with medical insurance [odds ratio (OR)=0.118, 95% confidence interval (CI) (0.021, 0.671), P=0.016], postoperative pain [OR=3.379, 95%CI (1.164, 9.812), P=0.025], bilateral lesions [OR=3.842, 95%CI (1.040, 14.191), P=0.044], and MAAS score ≥68 [OR=0.046, 95%CI (0.018, 0.121), P<0.001] were independent predictive factors for sleep disorders (P<0.05). Conclusion Postoperative pain reduction and mindfulness training may improve the patients’ sleep quality and reduce the incidence of sleep disorders.
高血压是我国重点防治的心血管疾病, 血压的控制率备受关注。在一些血压控制不良的患者中睡眠呼吸暂停是导致顽固性高血压的重要原因。以睡眠过程中反复、频繁出现呼吸暂停和低通气为特点的睡眠呼吸暂停低通气综合征( sleep apneahypopnea syndrome, SAHS) 自20 世纪80 年代以来也受到广泛关注, 临床和基础研究取得了迅速发展。目前, 多项临床、流行病学和基础研究证实SAHS可以导致和/ 或加重高血压, 与高血压的发生发展密切相关。
ObjectiveTo determine the correlation between obstructive sleep apnea syndrome (OSAS) and nonarteritic ischemic optic neuropathy (NAION).MethodsIt was a perspective study. A total of 41 consecutive patients with NAION (NAION group) and 41 age- and sex-matched physical examination subjects (control group) in Xi’an No.3 Hospital from December 2016 to December 2018 were enrolled in this study. The apnea hypopnea index (AHI, the number of sleep apneas per hour) was monitored using a polysomnography for patients in NAION group and control group. At the same time, the blood oxygen saturation was continuously recorded. The OSAS can be diagnosed if the AHI value was ≥5. OSAS severity was graded as mild: 5≤AHI＜15; moderate: 15≤AHI＜30; severe: AHI ≥30. The grading of OSAS severity between two groups was compared by Fisher's exact test. The AHI and minimum blood oxygen saturation were compared between NAION group and control group using the Mann-Whitney U test. Spearman correlation analysis was performed on the correlation between OSAS and NAION.ResultsAmong the patients in the NAION group, 31 patients (75.61%) were diagnosed with OSAS. Among them, 6 patients (14.63%) were mild, 9 patients (21.95%) were moderate, and 16 patients (39.03%) were severe. In the control group, 19 patients (46.34%) were diagnosed with OSAS. Among them, 10 patients (24.39%) were mild, 5 patients (12.20%) were moderate, and 4 patients (9.75%) were severe. The difference of OSAS patients of mild, moderate and severe between two groups were statistically significant (Z=0.235, 0.245, 0.312; P=0.012, 0.014, 0.032). The average AHI of patients in the NAION group was 20.25±7.74, and the mean minimum oxygen saturation at night was (87.38±5.53)%. The average AHI of the control group was 18.67±11.67, and the mean minimum oxygen saturation at night was (85.06+4.25)%. The differences of the mean AHI and mean minimum oxygen saturation between two groups were statistically significant (Z=1.124, 2.317, P=0.003, 0.020). There was a positive correlation between OSAS and NAION (Spearman correlation coefficient=0.229, P=0.030).ConclusionThere is a positive correlation between OSAS and NAION.
Sleep deprivation can cause hyperalgesia, and the mechanisms involve glutamic acid, dopamine, serotonin, metabotropic glutamate receptor subtype 5, adenosine A2A receptor, nicotinic acetylcholine receptor, opioid receptor, brain-derived neurotrophic factor, melatonin, etc. The mechanisms of hyperalgesia caused by sleep deprivation are complex. The current treatment methods are mainly to improve sleep and relieve pain. This paper reviews the mechanism and treatment progress of hyperalgesia induced by sleep deprivation, and aims to provide scientific evidence for the treatment of hyperalgesia caused by sleep deprivation.
Sleep disorder is related to many comorbidities, such as diabetes, obesity, cardiovascular diseases, and hypertension. Because of its increasing prevalence rate, it has become a global problem that seriously threatens people’s health. Various forms of sleep disorder can cause increased insulin resistance and/or decreased sensitivity, thus affecting the occurrence, development and prognosis of diabetes. However, sleep health has not been paid attention to in recent years. Therefore, this article summarizes the findings of the correlation between sleep disorder and diabetes mellitus in recent years, by elaborating the relationship between various types of sleep disorder (including sleep apnea syndrome) and diabetes mellitus, as well as their mechanisms and intervention measures, in order to enhance the attention of clinical workers to sleep health, and to provide basis for reducing the risk of diabetes.