Sleep disorder symptoms are common and unspoken in Canadian general practice
Sleep disorder symptoms are common and unspoken in Canadian general practice
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DOI：
10.1093/fampra/cmp031
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发表时间：
2009-08-01
期刊：
影响因子：
2.2
通讯作者：
Libman, Eva
中科院分区：
文献类型：
--
作者：
Bailes, Sally;Baltzan, Marc;Libman, Eva
方法.我们招募了两个样本：191名老年初级保健患者和138名睡眠诊所患者。参与者完成了睡眠症状检查表（SSC）。这包括四个领域的21种症状：失眠，睡眠障碍，日间症状和心理困扰。所有受访者都指出了在过去一年中与他们的医生讨论过哪些症状。初级保健受试者被指定为下降者（完成SSC，拒绝进一步评估），脱落者（完成一些评估步骤，但未完成多导睡眠图（PSG））和完成者（完成PSG）。初级保健参与者经常有症状，但相对较少与他们的医生讨论。睡眠诊所的参与者与他们的转诊医生讨论的症状明显多于初级保健辍学或下降的所有类别，除了心理困扰。初级保健完成者中有88.5%最终被诊断为睡眠呼吸暂停/低通气综合征和/或周期性肢体运动障碍，他们讨论睡眠障碍症状的频率也低于睡眠诊所患者，但往往更突出失眠和日间功能受损的症状。研究结果表明，初级保健患者经常有他们不讨论的症状，即使存在原发性睡眠障碍。在我们的实验室中开发的简短SSC检查表有可能提高患有睡眠障碍的老年初级保健患者的转诊率。
Methods. We recruited two samples: 191 older Primary care patients and 138 Sleep clinic patients. Participants completed the Sleep Symptom Checklist (SSC). This consists of 21 symptoms in four domains: insomnia, sleep disorder, daytime symptoms and psychological distress. All respondents indicated which symptoms had been discussed with their physician in the past year. Primary care subjects were designated as Decliners (completed SSC, refused further evaluation), Dropouts [completed some evaluation steps, but not polysomnography (PSG)] and Completers (completed PSG).Results. Primary care participants frequently had symptoms but relatively few had discussed them with their doctor. Sleep clinic participants discussed significantly more symptoms with their referring physician than did Primary care Dropouts or Decliners in all categories except psychological distress. Primary care Completers, 88.5% of whom were ultimately diagnosed with sleep apnoea/hypopnoea syndrome and/or periodic limb movement disorder, also discussed their sleep disorder symptoms less frequently than did Sleep clinic patients but tended to give more prominence to symptoms of insomnia and impaired daytime function.Conclusions. The findings suggest that Primary care patients often have symptoms they do not discuss, even when a primary sleep disorder exists. The brief SSC checklist, developed in our laboratory, has potential to improve the referral rates of older primary care patients who have sleep disorder.