Sleep disorders

睡眠障碍
  • 文章类型: Journal Article
    背景:这项研究调查了受Türkiye2023年地震灾害影响的人群中头晕和睡眠质量的存在,旨在确定头晕与睡眠障碍之间的关系。
    方法:共有384名地震幸存者被纳入研究,这些幸存者以前没有头晕或睡眠障碍的抱怨,并且在地震后出现头晕或睡眠障碍的神经科门诊。记录参与者的人口统计信息和量表,例如头晕障碍量表(DHI)和匹兹堡睡眠质量指数(PSQI)。
    结果:确定18-35岁年龄组的大多数患者睡眠质量较差,PSQI评分存在显着差异。此外,DHI评分和PSQI评分之间存在中度正相关.
    结论:遭受大地震和余震会导致睡眠障碍和头晕,这可能会成为公共卫生问题。地震灾民应采取后续行动,并尽早采取必要的干预措施。
    BACKGROUND: This study investigated the presence of dizziness and sleep quality in people affected by the earthquake disaster of 2023 in Türkiye and aimed to determine the relationship between dizziness and sleep disorders.
    METHODS: A total of 384 earthquake survivors who had no previous complaints of dizziness or sleep disturbance and who presented to the neurology outpatient clinic with complaints of dizziness or sleep disturbance after the earthquake were included in the study. Demographic information of participants and scales such as the Dizziness Handicap Inventory (DHI) and the Pittsburgh Sleep Quality Index (PSQI) were recorded.
    RESULTS: It was determined that the majority of the patients in the 18-35 age group had poor sleep quality and there was a significant difference in the PSQI score. Additionally, a moderate positive significant relationship was found between the DHI score and the PSQI score.
    CONCLUSIONS: Exposure to major earthquakes and aftershocks can cause sleep disorders and dizziness complaints, which may emerge as public health problems. Earthquake victims should be followed up and necessary interventions should be made early.
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  • 文章类型: Journal Article
    系统评估高压氧疗法(HBOT)作为帕金森病(PD)患者睡眠障碍的辅助疗法的疗效。
    从成立到2023年9月,我们在八个数据库中进行了全面搜索,包括PubMed,科克伦图书馆,Embase,WebofScience,SinoMed,中国国家知识基础设施(CNKI),中国科技期刊数据库(VIP),和万方数据库。目的是确定随机对照试验(RCT),评估HBOT作为辅助治疗在缓解PD患者睡眠障碍症状方面的有效性。文献筛选和数据提取由作者独立执行。使用ReviewManager5.3软件进行Meta分析,使用Stata17.0软件评估发表偏倚和敏感性分析。
    纳入了7项RCT,涉及461名参与者。研究结果表明,HBOT的添加显着提高了睡眠效率(MD=15.26,95%CI[10.89,19.63],p<0.00001),卧床时间增加(MD=69.65,95%CI[43.01,96.30],p<0.00001),总睡眠时间(MD=75.87,95%CI[25.42,126.31],p=0.003),慢波睡眠(SWS)时间(MD=6.14,95%CI[3.95,8.34],p<0.00001),和快速眼动睡眠(REM)时间(MD=4.07,95%CI[2.05,6.08],p<0.0001),觉醒频率降低(MD=-11.55,95%CI[-15.42,-7.68],p<0.00001)和睡眠潜伏期(MD=-6.60,95%CI[-9.43,-3.89],p<0.00001)。此外,匹兹堡睡眠质量指数(PSQI)显着改善(MD=-2.52,95%CI[-2.85,-2.18],p<0.00001),Epworth嗜睡量表(ESS)(MD=-2.90,95%CI[-3.34,-2.47],p<0.00001),统一帕金森病评定量表第三部分(UPDRSIII)(MD=-1.32,95%CI[-2.16,-0.47],p=0.002),和Hoehn和Yahr分级(H-Y分级)(MD=-0.15,95%CI[-0.28,-0.01],p=0.03)。
    当前的荟萃分析支持HBOT作为治疗PD患者睡眠障碍的辅助疗法的有效性。建议用于经历睡眠障碍的PD患者。系统审查注册:https://www。crd.约克。AC.英国/,标识符:CRD42023462201。
    UNASSIGNED: To systematically evaluate the efficacy of hyperbaric oxygen therapy (HBOT) as an adjunct therapy for treating sleep disorders in patients with Parkinson\'s disease (PD).
    UNASSIGNED: We conducted comprehensive searches in eight databases from inception through September 2023, including PubMed, Cochrane Library, Embase, Web of Science, SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP), and Wanfang Database. The objective was to identify randomized controlled trials (RCTs) evaluating HBOT\'s effectiveness in alleviating sleep disorder symptoms in PD patients as an adjunct therapy. Literature screening and data extraction were independently executed by the authors. Meta-analyses were performed using Review Manager 5.3 software, and publication bias and sensitivity analyses were assessed using Stata 17.0 software.
    UNASSIGNED: Seven RCTs involving 461 participants were included. The findings revealed that the addition of HBOT significantly enhanced sleep efficiency (MD = 15.26, 95% CI [10.89, 19.63], p < 0.00001), increased time in bed (MD = 69.65, 95% CI [43.01, 96.30], p < 0.00001), total sleep time (MD = 75.87, 95% CI [25.42, 126.31], p = 0.003), slow-wave sleep (SWS) time (MD = 6.14, 95% CI [3.95, 8.34], p < 0.00001), and rapid eye movement sleep (REM) time (MD = 4.07, 95% CI [2.05, 6.08], p < 0.0001), and reduced awakening frequency (MD = -11.55, 95% CI [-15.42, -7.68], p < 0.00001) and sleep latency (MD = -6.60, 95% CI [-9.43, -3.89], p < 0.00001). Additionally, significant improvements were observed in the Pittsburgh Sleep Quality Index (PSQI) (MD = -2.52, 95% CI [-2.85, -2.18], p < 0.00001), Epworth Sleepiness Scale (ESS) (MD = -2.90, 95% CI [-3.34, -2.47], p < 0.00001), Unified Parkinson\'s Disease Rating Scale Part III (UPDRS III) (MD = -1.32, 95% CI [-2.16, -0.47], p = 0.002), and Hoehn and Yahr grading (H-Y grading) (MD = -0.15, 95% CI [-0.28, -0.01], p = 0.03).
    UNASSIGNED: The current meta-analysis supports the efficacy of HBOT as an adjunct therapy in managing sleep disorders in PD patients. It is recommended for PD patients experiencing sleep disturbances.Systematic review registration:https://www.crd.york.ac.uk/, identifier: CRD42023462201.
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  • 文章类型: Journal Article
    探讨COVID-19对支持湖北省的福建省医护人员睡眠的影响及其相关危险因素。
    横截面,匿名,在所有参与者中进行自我报告的在线问卷调查.问卷包括五个部分:社会人口统计学特征和COVID-19流行相关因素,匹兹堡睡眠质量指数(PSQI)Epworth嗜睡量表(ESS),早晨-均匀性问卷-5(MEQ-5),和12项一般健康问卷(GHQ-12)。
    在552名参与者中,203(36.8%)的PSQI评分>7,表明存在睡眠障碍。Logistic回归分析显示睡眠障碍与既往睡眠障碍病史独立相关(OR6.074,95%CI2.626-14.049,P<0.001),每周夜班>3次(OR3.089,95%CI1.650-5.781,P<0.001),睡眠前使用电子设备>1小时(OR1.685,95%CI1.131-2.511,P=0.010),对感染COVID-19的关注(OR1.116,95%CI1.034-1.204,P=0.005),湖北支持医护人员的社会支持感知(OR0.861,95%CI0.744-0.998,P=0.047)(OR0.861,95%CI0.744-0.998,P=0.047),非医务人员(OR0.257,95%CI0.067-0.987,P=0.048),ESS评分(OR1.068,95%CI1.018-1.121,P=0.007),GHQ-12评分(OR1.511,95%CI1.281-1.782,P<0.001)。
    在COVID-19大流行期间,福建省支持湖北省的医护人员中睡眠障碍非常普遍。睡眠障碍的危险因素包括先前诊断的睡眠障碍史,每周轮夜班>3次,睡眠前使用电子设备>1小时,过度担心感染COVID-19,心理健康较差。更高的感知社会支持和对支持湖北的医护人员的支持的理解与睡眠障碍的风险降低有关。就像非医务人员一样。为一线医护人员提供更多的睡眠卫生教育和心理健康服务是必要的。
    UNASSIGNED: To explore the impact of COVID-19 on the sleep of healthcare workers from Fujian Province supporting Hubei Province and its related risk factors.
    UNASSIGNED: A cross-sectional, anonymous, self-reported online questionnaire survey was conducted among all participants. The questionnaire consisted of five parts: sociodemographic characteristics and COVID-19 epidemic-related factors, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Morningness-Eveningness Questionnaire-5 (MEQ-5), and 12-item General Health Questionnaire (GHQ-12).
    UNASSIGNED: Among 552 participants, 203 (36.8%) had a PSQI score > 7, indicating the presence of sleep disorders. Logistic regression analysis revealed that sleep disorders were independently associated with a history of previously diagnosed sleep disorders (OR 6.074, 95% CI 2.626-14.049, P < 0.001), rotating night shifts > 3 times per week (OR 3.089, 95% CI 1.650-5.781, P < 0.001), using electronic devices before sleep >1 h (OR 1.685, 95% CI 1.131-2.511, P = 0.010), concern about contracting COVID-19 (OR 1.116, 95% CI 1.034-1.204, P = 0.005), perception of societal support for supporting healthcare workers in Hubei (OR 0.861,95% CI 0.744-0.998, P = 0.047) (OR 0.861, 95% CI 0.744-0.998, P = 0.047), non-medical staff (OR 0.257, 95% CI 0.067-0.987, P = 0.048), ESS score (OR 1.068, 95% CI 1.018-1.121, P = 0.007), and GHQ-12 score (OR 1.511, 95% CI 1.281-1.782, P < 0.001).
    UNASSIGNED: Sleep disorders were highly prevalent among healthcare workers from Fujian Province supporting Hubei Province during the COVID-19 pandemic. Risk factors for sleep disorders included a history of previously diagnosed sleep disorders, rotating night shifts > 3 times per week, using electronic devices before sleep >1 h, excessive concern about contracting COVID-19, and poorer psychological health. Higher perceived societal support and understanding of support for healthcare workers supporting Hubei were associated with a reduced risk of sleep disorders, as was being non-medical staff. Providing more sleep hygiene education and psychological health services for frontline healthcare workers is necessary.
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  • 文章类型: Journal Article
    这项研究的目的是调查肠道微生物群与睡眠障碍之间的间接因果关系。
    在第1阶段,我们利用196个肠道微生物群作为暴露因子,对五种睡眠障碍进行了双样本单变量孟德尔随机化(MR)分析:失眠,白天过度嗜睡(EDS),睡眠-觉醒节律紊乱(SWRD),阻塞性睡眠呼吸暂停(OSA)和孤立性REM睡眠行为障碍(iRBD)。在阶段2中,我们通过16SrDNA测序比较患者和健康对照之间的粪便微生物群丰度来验证MR发现。在第三阶段,我们探索了微生物群影响睡眠的间接途径,使用205个肠道菌群代谢途径和9个常见的睡眠障碍危险因素作为网络MR分析的候选介质。
    在第1阶段,单变量MR分析确定了可能影响五种不同睡眠障碍的14种微生物群。在第2阶段,我们观察性研究的结果验证了其中四个关联。在第3阶段,网络MR分析显示,Negativicutes类和Selenomonadales顺序可能会通过增加疼痛而使失眠恶化[调解:12.43%(95%CI:0.47,24.39%)]。草酸杆菌属可通过破坏腺苷再摄取而提高EDS[25.39%(1.84,48.95%)]。Allisonella可能通过促进肥胖[36.88%(17.23,56.54%)]提高OSA风险,而嗜木杆菌组可以通过减少吸烟行为[7.70%(0.66,14.74%)]来降低OSA风险。
    来自MR和观察性研究的三角测量证据揭示了微生物群与睡眠障碍之间的间接因果关系,提供关于肠道微生物群如何调节睡眠的新观点。
    UNASSIGNED: The objective of this study is to investigate the indirect causalities between gut microbiota and sleep disorders.
    UNASSIGNED: In stage 1, we utilized 196 gut microbiota as the exposure factor and conducted a two-sample univariable Mendelian randomization (MR) analysis on five sleep disorders: insomnia, excessive daytime sleepiness (EDS), sleep-wake rhythm disorders (SWRD), obstructive sleep apnea (OSA), and isolated REM sleep behavior disorder (iRBD). In stage 2, we validated the MR findings by comparing fecal microbiota abundance between patients and healthy controls through 16S rDNA sequencing. In stage 3, we explored the indirect pathways by which the microbiota affects sleep, using 205 gut microbiota metabolic pathways and 9 common risk factors for sleep disorders as candidate mediators in a network MR analysis.
    UNASSIGNED: In stage 1, the univariable MR analysis identified 14 microbiota potentially influencing five different sleep disorders. In stage 2, the results from our observational study validated four of these associations. In stage 3, the network MR analysis revealed that the Negativicutes class and Selenomonadales order might worsen insomnia by increasing pain [mediation: 12.43% (95% CI: 0.47, 24.39%)]. Oxalobacter could raise EDS by disrupting adenosine reuptake [25.39% (1.84, 48.95%)]. Allisonella may elevate OSA risk via obesity promotion [36.88% (17.23, 56.54%)], while the Eubacterium xylanophilum group may lower OSA risk by decreasing smoking behavior [7.70% (0.66, 14.74%)].
    UNASSIGNED: Triangulation of evidence from the MR and observational study revealed indirect causal relationships between the microbiota and sleep disorders, offering fresh perspectives on how gut microbiota modulate sleep.
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  • 文章类型: Journal Article
    智能手机成瘾是数字时代的一种新兴成瘾类型,以智能手机依赖为特征,对人类健康产生负面影响,具有广泛的心理和身体表现。
    本研究旨在评估智能手机成瘾的详细临床表现,作为一种划定的临床综合征。
    采用横断面研究设计,使用智能手机成瘾量表(SAS-SV2013)评估叙利亚大学生的智能手机成瘾患病率及其对健康的影响。凯斯勒心理困扰量表(K-6),以及对文献中经常与智能手机成瘾相关的临床表现的综合评估。应用不同的统计建模技术;P值<0.05被认为具有统计学意义。
    在1532名受邀本科生中,1401(91.45%)充分完成评估。大多数参与者是女性(59.7%)和23岁以下(73.2%)。智能手机成瘾的患病率为67.80%;具有统计学意义的智能手机成瘾关联与心理困扰(P<.0001),比值比为3.308。大多数筛查的身体表现也显示出与智能手机成瘾的显着关联。
    观察到智能手机成瘾的患病率很高,伴随着广泛的相关精神和身体表现。随着智能设备成瘾成为全球健康问题,将相关文献中报道的临床发现合并为一个临床身份是开发针对所描绘的临床综合征的整体管理方法所必需的.
    UNASSIGNED: Smartphone addiction is an emerging type of addiction in the digital era, characterized by smartphone dependence that negatively affects human health with a wide range of psychological and physical manifestations.
    UNASSIGNED: This study aimed to evaluate the detailed clinical manifestations of smartphone addiction as a delineated clinical syndrome.
    UNASSIGNED: A cross-sectional study design was employed to assess smartphone addiction prevalence and its health impacts among Syrian undergraduates using the Smartphone Addiction Scale-Short Version (SAS-SV 2013), the Kessler psychological distress scale (K-6), and a comprehensive assessment of the clinical manifestations frequently linked to smartphone addiction in the literature. Different statistical modeling techniques were applied; a P value of < .05 was considered statistically significant.
    UNASSIGNED: Of 1532 invited undergraduates, 1401 (91.45%) completed the assessment adequately. Most participants were females (59.7%) and below 23 years of age (73.2%). The prevalence of smartphone addiction was 67.80%; statistically significant smartphone addiction associations were revealed with psychological distress (P < .0001) with odds ratios of 3.308. Most screened physical manifestations also showed a significant association with smartphone addiction.
    UNASSIGNED: A high prevalence of smartphone addiction was observed with a broad spectrum of associated mental and physical manifestations. As smart device addiction becomes a global health concern, combining the clinical findings reported in the related literature into one clinical identity is necessary to develop a holistic management approach for the delineated clinical syndrome.
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  • 文章类型: Journal Article
    心理健康是精英运动员日益关注的领域。
    确定精英运动员心理健康症状的性别差异。
    PubMed,EMBASE,使用Cochrane图书馆数据库。
    纳入的研究包括按性别比较运动员的心理健康症状。
    按照PRISMA指南进行系统评价和荟萃分析。
    2a级。
    比率(RR)计算为男女运动员的比率。使用随机效应模型汇集数据。
    在确定的1945篇文章中,共包括60篇文章。男性运动员报告酒精滥用较高(RR,0.74;CI,0.68-0.80),非法药物滥用(RR,0.82;CI,0.75-0.89),和赌博问题(RR,0.14;CI,0.08-0.25)。女运动员报告的整体焦虑较高(RR,1.17;CI,1.08-1.27),抑郁症(RR,1.42;CI,1.31-1.54),遇险(RR,1.98;CI,1.40-2.81),和饮食紊乱(RR,2.19;CI,1.58-3.02)。据报道,男性和女性运动员的睡眠障碍发生率相似(RR,1.13;CI,0.98-1.30)。
    男女运动员在报告的心理健康症状方面存在显着差异。女运动员更容易报告焦虑,抑郁症,苦恼,和无序的饮食,虽然男性运动员报告更多的酒精滥用,非法药物滥用,和赌博。监测和评估心理健康是任何运动的必要组成部分,包括访问资源。随着时间的推移,对运动员进行纵向研究,以确定心理健康症状的发展和原因,应包括在未来的研究方向中。
    UNASSIGNED: Mental health is a growing area of concern for elite athletes.
    UNASSIGNED: To determine the sex differences in mental health symptoms in elite athletes.
    UNASSIGNED: PubMed, EMBASE, and Cochrane Library databases were used.
    UNASSIGNED: Included studies included comparisons of mental health symptoms of athletes by sex.
    UNASSIGNED: Systematic review and meta-analysis were conducted following the PRISMA guidelines.
    UNASSIGNED: Level 2a.
    UNASSIGNED: The rate ratio (RR) was calculated as the rates in female and male athletes. Data were pooled using a random-effects model.
    UNASSIGNED: Of 1945 articles identified, 60 articles were included. Male athletes reported higher alcohol misuse (RR, 0.74; CI, 0.68-0.80), illicit drug abuse (RR, 0.82; CI, 0.75-0.89), and gambling problems (RR, 0.14; CI, 0.08-0.25). Female athletes reported higher overall anxiety (RR, 1.17; CI, 1.08-1.27), depression (RR, 1.42; CI, 1.31-1.54), distress (RR, 1.98; CI, 1.40-2.81), and disordered eating (RR, 2.19; CI, 1.58-3.02). Sleep disturbances were reported at similar rates in male and female athletes (RR, 1.13; CI, 0.98-1.30).
    UNASSIGNED: Female and male athletes have significant differences in reported mental health symptoms. Female athletes are more likely to report anxiety, depression, distress, and disordered eating, while male athletes report more alcohol misuse, illicit drug abuse, and gambling. Monitoring and evaluation of mental health is a necessary part of any sport, including access to resources. Longitudinal studies following athletes over time to determine the development and causation for mental health symptoms should be included in future research directions.
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  • 文章类型: Journal Article
    目前的证据表明,缺铁(ID)在表现为不安的疾病的发病机理中起着关键作用,例如注意力缺陷多动障碍(ADHD)和不宁腿综合征(RLS)。在临床实践中,在这种情况下,诊断检查和/或作为治疗选择不常规考虑ID和铁补充剂。因此,我们对ID指南进行了范围研究文献综述.在包括的58条准则中,只有9个包括RLS,3包括ADHD。铁蛋白是最常被引用的生物标志物,虽然截止值在指南和年龄等其他因素之间有所不同,性别,和合并症。围绕可测量的铁生物标志物和截止值的建议在指南之间有所不同;此外,尽管抓住了炎症作为一个概念的作用,大多数指南通常不包括如何评估这一点的建议.铁和炎症生物标志物的解释缺乏协调,这引发了人们对当前指南在临床实践中的适用性的质疑。Further,本综述中的大多数ID指南不包括ID相关疾病,ADHD和RLS由于ID可以与改变的运动模式相关联,在不同临床表型的背景下,研究和解释铁的状态需要一个新的共识.
    Current evidence suggests that iron deficiency (ID) plays a key role in the pathogenesis of conditions presenting with restlessness such as attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS). In clinical practice, ID and iron supplementation are not routinely considered in the diagnostic work-up and/or as a treatment option in such conditions. Therefore, we conducted a scoping literature review of ID guidelines. Of the 58 guidelines included, only 9 included RLS, and 3 included ADHD. Ferritin was the most frequently cited biomarker, though cutoff values varied between guidelines and depending on additional factors such as age, sex, and comorbidities. Recommendations surrounding measurable iron biomarkers and cutoff values varied between guidelines; moreover, despite capturing the role of inflammation as a concept, most guidelines often did not include recommendations for how to assess this. This lack of harmonization on the interpretation of iron and inflammation biomarkers raises questions about the applicability of current guidelines in clinical practice. Further, the majority of ID guidelines in this review did not include the ID-associated disorders, ADHD and RLS. As ID can be associated with altered movement patterns, a novel consensus is needed for investigating and interpreting iron status in the context of different clinical phenotypes.
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  • 文章类型: Journal Article
    简介:轮班员工面临许多影响健康的威胁,生活质量和工作安全。那些只在晚上工作的人特别脆弱。审查的目的是确定对健康的风险,轮班卫生工作者的生活质量和睡眠质量。方法:采用系统评价(SR)进行分析。搜索了电子数据库。搜索仅限于过去五年发表的最新研究:2019-2023。结果:最后,36篇文章被纳入审查。大多数作者已经表明睡眠障碍或其质量与轮班工作/夜间工作之间存在联系。此外,与其他工作时间表相比,三班制时间表是主观睡眠质量较差的最重要因素.此外,许多作者已经证明了轮班/夜班与健康问题之间的联系,其中包括心脏代谢风险,葡萄糖不耐受,乳腺癌和免疫脆弱性。结论:研究结果清楚地表明,夜间工作对睡眠障碍和健康障碍的风险增加有重大影响。医护人员应该意识到与夜班相关的风险,以便采取措施防止睡眠/健康问题。轮班/夜班工人应该有机会接受与工作相关的疾病筛查。
    Introduction: Employees working in shifts are exposed to many threats affecting their health, quality of life and safety at work. Those who perform their work only at night are particularly vulnerable. The purpose of the review is to identify risks to the health, quality of life and sleep of shift health workers. Method: A systematic review (SR) was used in the analysis. Electronic databases were searched. The search was limited to the latest studies published in the last five years: 2019-2023. Results: Finally, 36 articles were included in the review. Most authors have shown a link between sleep disturbance or its quality and shift work/night work. Moreover, a three-shift schedule was the most significant factor for poorer subjective sleep quality when compared to other work schedules. Furthermore, many authors have shown a link between shift/night work and health problems, which include cardiometabolic risk, glucose intolerance, breast cancer and immune vulnerability. Conclusions: The research results clearly show a significant impact of night work on the increased risk of sleep disorders and health disturbance. Healthcare workers should be aware of the risks associated with night work in order to take measures preventing sleep/health problems. Shift/night workers should have the opportunity to be screened for disorders linked with their work.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估德国成年抑郁症住院患者的住院时间(LoS)及其相关因素。方法:这项横断面研究包括2019年1月至2023年12月在德国36家医院接受治疗的所有抑郁症住院的成年人(≥18岁)。主要结局是患者住院天数。年龄之间的关联,性别,抑郁症的严重程度,共同诊断,医院,和医院LoS使用分层多变量线性回归模型进行分析。结果:共有6579例患者(平均年龄46.6±17.7岁),有8965例抑郁症住院。平均住院LoS为35.2天。严重抑郁症(+4.9天)与更长的医院LoS有关,以中度抑郁为参考。年龄较大与更长的医院LoS呈正相关。维生素D缺乏(+9天),脂质代谢紊乱(+8天),肥胖(+8天),睡眠障碍(+7天),对严重压力和适应障碍的反应(+5天)也与医院LoS显著相关。结论:在抑郁症患者中,抑郁严重程度更高,高龄,维生素D缺乏,脂质代谢紊乱,肥胖,睡眠障碍,对严重压力的反应,和调整障碍与更长的医院LoS相关。通过全面和综合的护理策略解决这些因素可以帮助优化住院时间并改善总体患者预后。
    Objective: The aim of the present study was to evaluate the hospital length of stay (LoS) and its associated factors among adult patients hospitalized with depression in Germany. Methods: This cross-sectional study included all adults (≥18 years) hospitalized with depression from January 2019 to December 2023 treated in 36 hospitals across Germany. The primary outcome was patients\' hospital LoS in days. The associations between age, sex, depression severity, co-diagnoses, hospital, and hospital LoS were analyzed using hierarchical multivariable linear regression models. Results: A total of 6579 patients (mean age 46.6 ± 17.7 years) with 8965 hospitalizations for depression were available. The mean hospital LoS was 35.2 days. Severe depression (+4.9 days) was associated with a longer hospital LoS, with moderate depression as the reference. Older age was positively associated with a longer hospital LoS. Vitamin D deficiency (+9 days), lipid metabolism disorders (+8 days), obesity (+8 days), sleep disorders (+7 days), and reaction to severe stress and adjustment disorders (+5 days) were also significantly associated with hospital LoS. Conclusions: In patients with depression, higher depression severity, advanced age, vitamin D deficiency, lipid metabolism disorders, obesity, sleep disorders, reactions to severe stress, and adjustment disorders were associated with a longer hospital LoS. Addressing these factors through comprehensive and integrated care strategies could help optimize hospitalization duration and improve overall patient outcomes.
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  • 文章类型: Journal Article
    睡眠之间的三重相互作用,豁免权,和癌症代表了生物医学研究的一个不断增长的领域,具有重要的临床意义。这篇综述综合了目前关于睡眠如何影响免疫功能的知识,免疫系统在癌症动力学中的作用,以及睡眠模式和癌症风险之间的直接联系。在全面概述了这三个领域之间的相互关系之后,描述了睡眠在免疫功能中的机制,详细说明睡眠如何调节免疫系统,睡眠时间和质量对免疫反应的影响,以及潜在的分子和细胞机制。此外,探讨了免疫与癌症之间的复杂关系,强调免疫系统在癌症预防和进展中的作用,免疫监视,肿瘤微环境,以及免疫缺陷和免疫调节对癌症风险的影响。然后描述了睡眠和癌症之间的直接联系,提供流行病学证据将睡眠模式与癌症风险联系起来,影响癌症发展的生物学机制,以及睡眠障碍在癌症预后中的作用。睡眠在免疫和癌症之间的中介作用被强调,提出假设的途径,总结实验和临床研究的证据,并评估睡眠干预对免疫功能和癌症预后的影响。这篇综述最后讨论了临床意义和未来的方向,强调睡眠干预在癌症预防和治疗中的潜力,肿瘤和免疫治疗的睡眠管理的整合,并概述了未来的研究议程。该议程包括了解睡眠-免疫-癌症相互作用的机制,对睡眠和癌症风险进行流行病学研究,评估睡眠管理对癌症治疗方案的影响,探索睡眠和肿瘤微环境的相互作用,并考虑政策和公共卫生影响。通过对这些相互关联的途径的详细检查,这篇综述强调了睡眠在调节免疫功能和癌症预后方面的重要性,倡导跨学科研究和临床策略,以利用这些知识改善健康结果。
    The triadic interplay between sleep, immunity, and cancer represents a growing area of biomedical research with significant clinical implications. This review synthesizes the current knowledge on how sleep influences immune function, the immune system\'s role in cancer dynamics, and the direct connections between sleep patterns and cancer risk. After a comprehensive overview of the interrelationships among these three domains, the mechanisms of sleep in immune function are described, detailing how sleep regulates the immune system, the effects of sleep duration and quality on immune responses, and the underlying molecular and cellular mechanisms. Also, the complex relationship between immunity and cancer is explored, highlighting the immune system\'s role in cancer prevention and progression, immune surveillance, tumor microenvironment, and the implications of immunodeficiency and immune modulation on cancer risk. The direct connections between sleep and cancer are then described, presenting epidemiological evidence linking sleep patterns to cancer risk, biological mechanisms that influence cancer development, and the role of sleep disorders in cancer prognosis. The mediating role of sleep between immunity and cancer is highlighted, proposing hypothesized pathways, summarizing evidence from experimental and clinical studies, and evaluating the impact of sleep interventions on immune function and cancer outcomes. This review concludes by discussing the clinical implications and future directions, emphasizing the potential for sleep-based interventions in cancer prevention and treatment, the integration of sleep management in oncology and immunotherapy, and outlining a future research agenda. This agenda includes understanding the mechanisms of the sleep-immunity-cancer interplay, conducting epidemiological studies on sleep and cancer risk, assessing the impact of sleep management in cancer treatment protocols, exploring sleep and tumor microenvironment interactions, and considering policy and public health implications. Through a detailed examination of these interconnected pathways, this review underscores the critical importance of sleep in modulating immune function and cancer outcomes, advocating for interdisciplinary research and clinical strategies to harness this knowledge for improved health outcomes.
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