围绝经期和绝经后女性睡眠质量与日常认知功能的相关性

doi:10.3969/j.issn.1674-8115.2021.04.013

摘要/Abstract

摘要：

目的·评估围绝经期和绝经后女性的睡眠质量与日常认知功能的相关性。方法·281名初次就诊于上海市第六人民医院绝经门诊的女性被纳入研究。一般资料调查问卷获取患者社会人口统计学特征。匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）评估睡眠质量及其7个维度（睡眠潜伏期、睡眠持续时间、睡眠效率、睡眠障碍、主观睡眠质量、催眠药物和日间功能障碍）。简短版日常认知功能量表（Everyday Cognition 12，Ecog-12）评估日常认知功能。采用Mann-Whitney U（两个独立样本）或Kruskal-Wallis H（多个独立样本）检验对患者的日常认知功能进行单因素分析。使用Spearman等级相关分析睡眠质量及7个维度与日常认知功能的关系。多元线性逐步回归法用来分析日常认知功能的影响因素。结果·281名研究对象Ecog-12得分为1.42（1.17，1.67）分，PSQI得分为6.0（3.0，10.0）分，约40.9%的围绝经期和绝经后期女性睡眠质量差（PSQI≥8）。患者日常认知功能在所有社会人口统计学特征变量（年龄、体质量指数、月收入、职业状况、文化程度、绝经状态、产次、规律运动、慢性疾病史）中均无统计学差异。相比睡眠质量好的妇女，睡眠质量差的妇女Ecog-12得分更高（P=0.000）。相关分析表明，PSQI的7个维度得分和总分均与Ecog-12得分呈正相关（P=0.000）。多元线性回归分析显示，催眠药物和日间功能障碍对日常认知功能下降的解释率为12.6%。结论·催眠药物和日间功能障碍是围绝经期和绝经后女性日常认知功能下降的独立影响因素。睡眠障碍的围绝经期和绝经后女性应慎重服用催眠药物，积极改善睡眠质量，保持良好的日间功能，避免或减轻睡眠问题造成的认知功能损害。

关键词: 围绝经期, 绝经后期, 睡眠质量, 日常认知功能, 催眠药物, 日间功能障碍

Abstract:

Objective· To evaluate the correlation between sleep quality and everyday cognitive function in perimenopausal and postmenopausal women.

Methods· Two hundred and eighty one women who visited the menopause clinic of Shanghai Sixth People's Hospital for the first time were included in the study. Socialdemographic characteristics of the patients were obtained by using the general information questionnaire. Pittsburgh Sleep Quality Index (PSQI) was used toassess sleep quality and its seven dimensions (sleep latency, sleep duration, sleep efficiency, sleep disturbance, subjective sleep quality, sleep medicationand daytime dysfunction).Everyday cognitive function was assessed by using the short version of Everyday Cognition (Ecog-12). Mann-Whitney U (two independent samples) or Kruskal-Wallis H (multiple indepentdent samples) test was used for univariate analysis of patents' everyday cogitive function.Spearman rank correlation was used to analyze the relationship of sleep quality and its seven dimensions with everyday cognitive function.Multiple linear stepwise regressionwas used to analyze the influencing factors of everyday cognitive function.

Results· The Ecog-12 score of 281 women was 1.42 (1.17,1.67). The score of PSQI was 6.0 (3.0, 10.0). 40.9% of perimenopausal and postmenopausal women had poor sleep quality (PSQI≥8). There was no statisticaldifference in patients' everyday cognitive function among all social demographic characteristic variables (age, body mass index, monthly income, occupationstatus, educational level, menopausal status, parity, regular exercise and history of chronic diseases). Compared to women with good sleep quality,women with poor quality scored higher in Ecog-12 (P=0.000). Spearman correlation analysis showed that the scores of 7 dimensions of PSQI and totalscore of PSQI were positively correlated with Ecog-12 score (P=0.000). Multiple linear regression analysis showed that the explanation rate of sleep medication and daytime dysfunction on everyday cognitive function deline was 12.6%.

Conclusion· Sleep medication and daytime dysfunction are the independent influencing factors of everyday cognitive function decline in perimenopausal and postmenopausal women. Perimenopausal and postmenopausal women with sleep disturbance should take sleep medication considerately, actively improve sleep quality, maintain good daytime function, andavoid or reduce cognitive impairment caused by sleep problems.

Key words: perimenopause, postmenopause, sleep quality, everyday cognitive function, sleep medication, daytime dysfunction

中图分类号:

R711

黄文俊, 蒋素素, 陶敏芳. 围绝经期和绝经后女性睡眠质量与日常认知功能的相关性[J]. 上海交通大学学报(医学版), 2021, 41(4): 497-501.

Wen-jun HUANG, Su-su JIANG, Min-fang TAO. Correlation between sleep quality and everyday cognitive function in perimenopausal and postmenopausal women[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(4): 497-501.

图/表 3

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Indicator	n(%)	Ecog-12
Indicator	n(%)	Score	Z /χ² value	P value
Age/year			2.036	0.361
40?44	26 (9.3)	1.48(1.15,1.77)
45?55	198 (70.5)	1.33 (1.08, 1.67)
56?65	57 (20.3)	1.42 (1.25, 1.71)
BMI/(kg·m^-2)			1.316	0.725
<18.5	16 (5.7)	1.42 (1.10, 1.98)
18.5?23.9	199 (70.8)	1.33 (1.17, 1.60)
24?27.9	54 (19.2）	1.42 (1.17, 1.58)
≥28	12 (4.3)	1.30 (1.02, 1.54)
Monthly income /yuan			4.045	0.257
<3 000	49 (17.4)	1.42 (1.25, 1.71)
3 000?5 000	61 (21.7)	1.42 (1.21, 1.71)
5 000?10 000	98 (34.9)	1.33 (1.08, 1.75)
>10 000	73 (26.0)	1.25 (1.08, 1.58)
Occupation status			1.868	0.393
Employed	197 (70.1)	1.33 (1.08, 1.67)
Unemployed	15 (5.3)	1.25 (1.17, 1.83)
Retired	69 (24.6)	1.42 (1.21, 1.79)
Educational level			0.429	0.807
Primary school and below	13 (4.6)	1.42 (1.25, 1.58)
High school	93 (33.1)	1.42 (1.17, 1.67)
University and above	175 (62.3)	1.33 (1.08, 1.75)
Menopausal status			1.436	0.488
Perimenopausal	146 (52.0)	1.33 (1.17, 1.75)
Early postmenopausal	87 (31.0）	1.42 (1.08, 1.58)
Late postmenopausal	48 (17.1)	1.42 (1.19, 1.81)
Parity			3.848	0.146
0	18 (6.4)	1.17 (1.08, 1.58)
1	224 (79.7)	1.42 (1.17, 1.73)
2?3	39 (13.9)	1.42 (1.25, 1.58)
Regular exercise			-0.642	0.521
No	180 (64.1)	1.33 (1.17, 1.67)
Yes	101 (35.9)	1.42 (1.17, 1.75)
Chronic disease
Hypertension			-0.343	0.732
No	238 (84.7)	1.41 (1.17, 1.69)
Yes	43 (15.3)	1.42 (1.17, 1.58)
Diabetes			-0.360	0.719
No	271 (96.4)	1.42 (1.17, 1.67)
Yes	10 (3.6)	1.46 (1.13, 2.06)
Sleep quality			-5.234	0.000
Good (PSQI<8)	166 (59.1)	1.25 （1.08，1.58）
Poor (PSQI ≥ 8)	115 (40.9)	1.58 （1.33，1.91）

Indicator	n(%)	Ecog-12
Indicator	n(%)	Score	Z /χ² value	P value
Age/year			2.036	0.361
40?44	26 (9.3)	1.48(1.15,1.77)
45?55	198 (70.5)	1.33 (1.08, 1.67)
56?65	57 (20.3)	1.42 (1.25, 1.71)
BMI/(kg·m^-2)			1.316	0.725
<18.5	16 (5.7)	1.42 (1.10, 1.98)
18.5?23.9	199 (70.8)	1.33 (1.17, 1.60)
24?27.9	54 (19.2）	1.42 (1.17, 1.58)
≥28	12 (4.3)	1.30 (1.02, 1.54)
Monthly income /yuan			4.045	0.257
<3 000	49 (17.4)	1.42 (1.25, 1.71)
3 000?5 000	61 (21.7)	1.42 (1.21, 1.71)
5 000?10 000	98 (34.9)	1.33 (1.08, 1.75)
>10 000	73 (26.0)	1.25 (1.08, 1.58)
Occupation status			1.868	0.393
Employed	197 (70.1)	1.33 (1.08, 1.67)
Unemployed	15 (5.3)	1.25 (1.17, 1.83)
Retired	69 (24.6)	1.42 (1.21, 1.79)
Educational level			0.429	0.807
Primary school and below	13 (4.6)	1.42 (1.25, 1.58)
High school	93 (33.1)	1.42 (1.17, 1.67)
University and above	175 (62.3)	1.33 (1.08, 1.75)
Menopausal status			1.436	0.488
Perimenopausal	146 (52.0)	1.33 (1.17, 1.75)
Early postmenopausal	87 (31.0）	1.42 (1.08, 1.58)
Late postmenopausal	48 (17.1)	1.42 (1.19, 1.81)
Parity			3.848	0.146
0	18 (6.4)	1.17 (1.08, 1.58)
1	224 (79.7)	1.42 (1.17, 1.73)
2?3	39 (13.9)	1.42 (1.25, 1.58)
Regular exercise			-0.642	0.521
No	180 (64.1)	1.33 (1.17, 1.67)
Yes	101 (35.9)	1.42 (1.17, 1.75)
Chronic disease
Hypertension			-0.343	0.732
No	238 (84.7)	1.41 (1.17, 1.69)
Yes	43 (15.3)	1.42 (1.17, 1.58)
Diabetes			-0.360	0.719
No	271 (96.4)	1.42 (1.17, 1.67)
Yes	10 (3.6)	1.46 (1.13, 2.06)
Sleep quality			-5.234	0.000
Good (PSQI<8)	166 (59.1)	1.25 （1.08，1.58）
Poor (PSQI ≥ 8)	115 (40.9)	1.58 （1.33，1.91）

Indicator	Ecog-12
Indicator	r value	P value
Subjective sleep quality	0.297	0.000
Sleep latency	0.179	0.000
Sleep duration	0.178	0.000
Sleep efficiency	0.210	0.000
Sleep disturbance	0.249	0.000
Sleep medication	0.259	0.000
Daytime dysfunction	0.325	0.000
PSQI total score	0.346	0.000

Indicator	Ecog-12
Indicator	r value	P value
Subjective sleep quality	0.297	0.000
Sleep latency	0.179	0.000
Sleep duration	0.178	0.000
Sleep efficiency	0.210	0.000
Sleep disturbance	0.249	0.000
Sleep medication	0.259	0.000
Daytime dysfunction	0.325	0.000
PSQI total score	0.346	0.000

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