睡眠疾患影響門診高血壓老年病患生活品質狀況之探討

Sleep Disorders and Health-related Quality of Life in the Elderly Hypertensive Patients

黃麗卿(Lee-Ching Hwang) ； 黃偉新(Wei-Hsin Huang) ； 鄒孟婷(Meng-Ting Tsou) ； 蔡悅琪(Yueh-Chi Tsai)

《台灣老年醫學雜誌》 2卷3期 (2007/02) Pp. 190-200

摘要

高血壓一般是沒有症狀，醫師在要求病患長期門診追蹤的同時，也應關心病患的生活品質。本研究欲了解門診高血壓老年病患的健康相關生活品質狀況，並探討睡眠疾患與相關因子是否會影響生活品質。
某醫學中心家庭醫學科門診高血壓個案，306人符合收案條件，平均年齡爲69.2歲。以問卷填寫方式，登錄基本資料、生活習慣與運動習慣，採用世界衛生組織的睡眠與健康全球專案計畫所建議之「失眠症自我評估表」評估睡眠，生活品質評估採用Medical Outcomes Study 36-item Short-Form Health Survey(SF-36)問卷。
研究結果顯示，有入睡困難者佔28.4%，難以維持睡眠者28.1%，早醒者22.6%，日間嗜睡感者有30.1%，任一型睡眠疾患者的比率爲65.0%。生活品質活力量表數值在沒有睡眠疾患者爲71.6，有睡眠疾患者平均低11分，情緒角色受限量表數值在沒有睡眠疾患者爲84.3，有睡眠疾患者平均低22分，多變項迴歸分析控制其他變項後，睡眠疾患仍顯著影響高血壓老年病患的生活品質，此外肥胖會降低而運動習慣會增加生活品質量表數值。
高血壓老年病患常見有睡眠疾患，且明顯影響其健康生活品質，臨床醫師照顧高血壓病患，應注重評估其睡眠疾患，並教育病患體重控制與養成運動習慣以改善病患生活品質。

關鍵字

高血壓 ； 睡眠疾患 ； 健康相關生活品質 ； SF-36

並列摘要

Background: High blood pressure generally is asymptomatic. For requesting patients' cooperation for long-term follow up, physicians should also pay close attention to patients' quality of life. The objectives of this study were to understand health related quality of life in elderly patients with hypertension and to evaluate the relationship between poor sleep and quality of life.
Methods: We recorded basic personal information and the patients' sleep conditions through two questionnaires: (1) the Self-reporting questionnaire of WHO Worldwide Project on Sleep, (2) the questionnaire on health-related quality of life based on the MOS (Medical Outcomes Study) 36-item Short-Form Health Survey (SF-36).
Results: A total of 306 elderly hypertensive patients followed up their treatment in family medicine clinics were enrolled in the study. The average age was 69.2±6.2 years old. The results showed that 65.0% of the elderly hypertensive patients had sleep disorders including: ”difficulty in falling asleep” (28.4%), ”difficulty in maintaining sleep” (28.1%), ”early awakening” (22.6%), and ”excessive daytime sleepiness” (30.1%). The prevalence of sleep disorders in the elderly hypertensive patients under study was higher than that in the general elderly population. The SF-36 Vitality Scale for those who slept well read 71.6 points while the average scale for poor sleepers dropped 11 points lower. In terms of emotion scale, those who slept well reported an average of 84.3 points, but it was 22 points lower for poor sleepers. Sleep disorder continued to show significant impact on the SF-36 Scales after controlling other variables in the multiple linear regression models. It was further observed that obesity brought down the scales while exercise habit raised them obviously.
Conclusion: In our study, two-thirds of the elderly hypertensive patients experienced ”poor sleep” that is significantly correlated with poorer quality of life. Clinicians caring hypertension should therefore pay attention to the evaluation of the sleep of their elderly patients, educate patients to manage weight, and encourage them to exercise for improving their quality of life.

並列關鍵字

hypertension ； sleep disorder ； health-related quality of life ； SF-36