노인 뇌졸중 환자에서 수면의 질과 연관된 임상 특징들
Clinical Characteristics Associated with Quality of Sleep in Old Stroke Patients : Preliminary Study
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Objectives:Although sleep problem is a common complaint in stroke survivors, there is paucity of studies on quality of sleep in old patients with stroke. The purpose of this study was to investigate the clinical characteristics associated with quality of sleep in old patients with stroke. Methods:A comprehensive clinical and psychiatric assessments was performed in 30 patients who were admitted in rehabili- tation department. Quality of sleep was evaluated with the Pittsburgh sleep quality index (PSQI). Other rating scales such as Modified Barthel Index, Korean mini mental state examination, Hamilton rating scale for anxiety, and Hamilton rating scale for depression were also performed to evaluate the clinical characteristics. Results:Thirteen patients (43%) were ‘poor sleeper’ defined as a global PSQI score >5. In the partial correlation test, poor sleeper group were significantly associated with anxiety (r=0.69, p<0.01) and depression (r=0.76, p<0.01). In the multivariate logistic regression analysis, depression symptoms (OR=1.51, p=0.01) were only significant predictor of ‘poor sleep’ compared with other factors including age, sex, stroke type, stoke location, stroke site, past medical history, anxiety, and cognitive function. Conclusion:The results may suggest that it is important to assess depression when old patients with stroke show decreased quality of sleep. Further following studies will be needed for finding relation with other clinical factors.
Abstract
Objectives:Although sleep problem is a common complaint in stroke survivors, there is paucity of studies on quality of sleep in old patients with stroke. The purpose of this study was to investigate the clinical characteristics associated with quality of sleep in old patients with stroke. Methods:A comprehensive clinical and psychiatric assessments was performed in 30 patients who were admitted in rehabili- tation department. Quality of sleep was evaluated with the Pittsburgh sleep quality index (PSQI). Other rating scales such as Modified Barthel Index, Korean mini mental state examination, Hamilton rating scale for anxiety, and Hamilton rating scale for depression were also performed to evaluate the clinical characteristics. Results:Thirteen patients (43%) were ‘poor sleeper’ defined as a global PSQI score >5. In the partial correlation test, poor sleeper group were significantly associated with anxiety (r=0.69, p<0.01) and depression (r=0.76, p<0.01). In the multivariate logistic regression analysis, depression symptoms (OR=1.51, p=0.01) were only significant predictor of ‘poor sleep’ compared with other factors including age, sex, stroke type, stoke location, stroke site, past medical history, anxiety, and cognitive function. Conclusion:The results may suggest that it is important to assess depression when old patients with stroke show decreased quality of sleep. Further following studies will be needed for finding relation with other clinical factors.
참고문헌 (22)
- world health report 2004, "World Health Organization", WHO, ~ (2004)
- Chemerinski E, "The neuropsychiatry of stroke", Psychosomatics, 41, pp.5~14 (2000)
- Kanner AM, "Should neurologists be trained to recognize and treat comorbid depression of neurologic disorders? Yes", Epilepsy Behav, 6, pp.303~311 (2005)
- Bagai K, "Obstructive sleep apnea, stroke, and cardiovascular diseases", Neurologist, 16, pp.329~339 (2010)
- Palomaki H, "Complaints of poststroke insomnia and its treatment with mianserin", Cerebrovasc Dis, 15, pp.56~62 (2003)
- Leppavuori A, "Insomnia in ischemic stroke patients", Cerebrovasc Dis, 14, pp.90~97 (2002)
- Xi Z, "REM sleep behavior disorder in a patient with pontine stroke", Sleep Med, 10, pp.143~146 (2009)
- Blanco M, "Hypersomnia and thalamic and brain stem stroke: a study of seven patients", Neurologia, 14, pp.307~314 (1999)
- Shah S, "Sensitivity of Shah, Vanclay and Cooper’s mo-dified Barthel Index", Clin Rehabil, 14, pp.551~552 (2000)
- Han C, "An adaptation of the Korean mini-mental state examination (K-MMSE) in elderly Koreans: Demographic influence and population-based norms (the AGE study)", ARCH GERONTOL GERIATR, 47, pp.302~310 (2008)
- Trajkovic G, "Reliability of the Hamilton Rating Scale for Depression: A meta-analysis over a period of 49years", Psychiatry Res (2009)
- Maier W, "The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders", J Affect Disord, 14, pp.61~68 (1988)
- Backhaus J, "Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia", J Psychosom Res, 53, pp.737~740 (2002)
- Pilcher JJ, "Sleep quality versus sleep qu-antity: relationships between sleep and measures of health, well-being and sleepiness in college students", J Psychosom Res, 42, pp.583~596 (1997)
- Blackman MR, "Age-related alterations in sleep quality and neuroendocrine function: interrelationships and implications", JAMA, 284, pp.879~881 (2000)
- Fagerstrom C, "Sleep complaints and their association with comorbidity and health-related quality of life in an older population in Sweden", Aging Ment Health, 15, pp.204~213 (2011)
- St George RJ, "Sleep quality and falls in older people living in self- and assisted-care villages", Gerontology, 55, pp.162~168 (2009)
- Zisberg A, "Contribution of routine to sleep quality in community elderly", Sleep, 33, pp.509~514 (2010)
- Ancoli-Israel S, "Insomnia in the elderly: a review for the primary care practitioner", Sleep, 23(1), pp.23~S38 (2000)
- Chen YK, "Clinical and radiologic correlates of insomnia symptoms in ischemic stroke patients", Int J Geriatr Psychiatry (2011)
- Autret A, "Sleep and brain lesions: a critical review of the literature and additional new cases", Neurophysiol Clin, 31, pp.356~375 (2001)
- Lugaresi E, "The thalamus and insomnia", Neurology, 42, pp.28~33 (1992)