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Subjective sleep quality in adult patients affected by Duchenne muscular dystrophy. Beyond nocturnal hypoventilation.
Sleep Medicine ( IF 4.8 ) Pub Date : 2020-02-04 , DOI: 10.1016/j.sleep.2020.01.025
Grazia Crescimanno 1 , Francesca Greco 2 , Alessia Abbate 2 , Maria Canino 3 , Manuela Bertini 3 , Oreste Marrone 4
Affiliation  

OBJECTIVE In stable neuromuscular patients under long-term non-invasive ventilation (NIV), subjective sleep quality may be predicted by chronic hypoventilation, as assessed by base excess (BE), and %N3 sleep stage duration. In this study, we explored how other variables, closely associated with self-reported health complaints, contributed to subjective sleep quality in adult patients with Duchenne muscular dystrophy (DMD). METHODS This is a secondary analysis of a quality of life study in 48 adult DMD patients under NIV therapy, with little evidence of residual hypoventilation. Subjective sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). A PSQI score >5 was considered indicative of poor sleep quality. Several other symptoms were evaluated: sleepiness, by the Epworth Sleepiness Scale (ESS); depression and anxiety, by the anxiety and depression subscales of the Hospital Anxiety and Depression Scale (HADS-A and HADS-D); autonomic symptoms, by the Composite Autonomic Symptom Score 31; pain, by the Numeric Pain Rating Scale (NPRS); and fatigue, by the Fatigue Severity Scale (FSS). RESULTS Mean PSQI was 6.1 ± 2.9. Abnormal scores were found for NPRS in 40, for HADS-A in 10 and for FSS in 24 subjects. The NPRS, HADS-A and FSS scores and the N3 sleep stage, independently predicted PSQI (R2 = 0.47, p < 0.0001). CONCLUSIONS In adult DMD patients, pain, fatigue and anxiety may have a prominent influence on subjective sleep quality. Improvement of sleep quality may be of utmost importance in DMD, as it may ameliorate quality of life and extend its benefits to cardiovascular morbidity and life expectancy.

中文翻译:

受杜氏肌营养不良症影响的成年患者的主观睡眠质量。除了夜间换气不足。

目的在长期无创通气(NIV)下稳定的神经肌肉患者中,可以通过慢性通气来预测主观睡眠质量,如通过基础过剩(BE)和%N3睡眠阶段持续时间来评估。在这项研究中,我们探讨了与自我报告的健康投诉密切相关的其他变量如何对成年杜氏肌营养不良症(DMD)患者的主观睡眠质量产生影响。方法这是对48例接受NIV治疗的成人DMD患者的生活质量研究的二级分析,几乎没有残余通气不足的证据。匹兹堡睡眠质量指数(PSQI)评估了主观睡眠质量。PSQI分数> 5被认为表明睡眠质量差。还评估了其他几种症状:嗜睡,通过爱泼华嗜睡量表(ESS);抑郁和焦虑,通过医院焦虑和抑郁量表的焦虑和抑郁量表(HADS-A和HADS-D);自主神经症状,通过综合自主神经症状评分31;疼痛,通过数字疼痛评分量表(NPRS)进行;疲劳严重程度量表(FSS)。结果平均PSQI为6.1±2.9。发现NPRS得分为40分,HADS-A得分为10分,FSS得分为24分。NPRS,HADS-A和FSS评分以及N3睡眠阶段独立预测PSQI(R2 = 0.47,p <0.0001)。结论在成年DMD患者中,疼痛,疲劳和焦虑可能对主观睡眠质量有显着影响。睡眠质量的改善在DMD中可能是最重要的,因为它可以改善生活质量并将其益处扩展至心血管疾病的发病率和预期寿命。
更新日期:2020-02-04
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