| Background:With the further development of modern sleep medicine, sleep disorders that affect a fairly common health problem for human health gradually caused the public health community’s attention and concern, while more and more people have sleep disorders related diseases, it has also become a hot research subject of many scholars. Domestic and international studies have confirmed that sleep disorders and diseases are closely related, sleep disorders can cause disease, and the disease will increase the sleep disorder, sleep quality worse,the quality of life is worse. Many studies have shown that sleep disorders can lead to human multi-system functional disorder in which patients with cardiovascular disease, a higher incidence of sleep disorders, and sleep deprivation has become an independent predictor of CHD risk. Sleep influences the occurrence, development and prognosis of CHDby changing the human metabolism, autonomic nervous function, hormone regulation and a series of physiological factors. As a coronary heart disease by a variety of risk factors coexist in the same individual,CHD has developed by synergistic effect of risk factors,and it also has high incidence, high recurrence rate, high morbidity and high mortality. CHD also through the body’s neurohumoral regulation and other factors cause sleep disorders. Therefore, in the process of interaction between coronary heart diseaseand sleep, appropriate interventions in the treatment of sleep disorders will reduce mortality in patients with coronary heart disease and improve the cure rate,it may survival become critical entry point. Focus on characteristics of sleep disorders in patients with coronary heart disease and appropriate control of sleep disorder are one of the important measures in clinical treatment and prevention of coronary heart disease.Objective:The present study retrospective analyze the sleep monitoring results of sleep structure, sleep apnea index and parasympathetic nerve intensity changes of whole body which are based on the research of CPC in unstable angina of coronary heart disease patients.It aims to explore the quality of sleep in patients with stable angina cases, also analyze correlation between sleep and the severity of coronary heart vessel disease, coronary heart disease associated with sleep apnea. Explore parasympathetic intensity variation which is based on one of the 12 two-hour periods of the day. Provide certain theoretical basis for the clinical treatment of coronary heart disease with sleep disorders, develop new mode of thinking in clinical work, raise the awareness of the importance of sleep disorders in chronic diseases, to guide the patients to follow reasonable health way of life, and effectively reduce the occurrence and development risks coronary heart disease.Methods:By October 2015 to March 2016, Collect the patients with unstable angina from the Department of Cardiology and the Department of combine traditional Chinese and western medicine of cardiology,china-Japanese Friendship Hospital, also the patients are Treated with coronary angiography and sleep monitoring.Coronary angiography patients are generally collected medical history, CPC sleep evaluation results (including the score of 24 hours sleep,sleep structure,24 hours state distribution of human physiological function,6 hour sleep-scale structure, etc.). Make a comparative analysis between the CHD group and control groups (health and sub-health population).depending on the severity of coronary, the CHD group was divided into three groups of comparison, while according to AHI index all object of study was divided into two groups (normal-mild OS AS group and moderate-severe OSAS group)of comparison, and based on one of the 12 two-hour periods of the day analyze the characteristics of physiological function of each group. Statistical analysis includes that Measurement data independent t-test, ANOVA, non-parametric test, bivariate correlation analysis, and count data using chi-square test and other statistical methods.Results:The clinical research results show that: ① Based on CPC evaluation of sleep quality in patients with coronary heart disease found that the lower score of sleep in patients,entering sleep time is long, deep sleep time is short, light sleep time and awake/ dream time is also long, AHI index is high (P<0.01); sleep in patients with coronary heart disease overall rating was significantly lower than the control group, and the lower deep sleep time, higher light sleep time, higher entering sleep time, and higher AHI apnea index all affect the quality of sleep, the difference was statistically significant (P<0.01, P<0.05); The incidence of coronary heart disease with varying degrees of sleep disorders is higher than health and sub-health groups, the difference was significant statistically significant (P<0.01);Coronary heart disease with insomnia patients compared with sub-health insomniac has lower sleep score (P< 0.05);compare two different sleep score of coronary heart disease patients and found that patients with coronary heart disease with insomnia have the shortest deep sleep time, the longest light sleep time, the longest entering sleep time and the highest apnea index, also it has the lowest overall rating of sleep (P<0.01); based on the time compare the sleep structure of the CHD groups and control group found that in patients with coronary heart disease midnight, Chou Shi, Mao Shi has a lower proportion of deep sleep (P<0.01); in Haishi, midnight, Chou Shi has a higher proportion of light sleep (P<0.01); and CHD groups were higher in Haishi, Zishi, Choushi, Yinshi,maoshi snoring proportion than the control group (P<0.01, P<0.05). ②Patients with coronary heart disease,the AHI respiratory index is higher, the entering sleep time and the light sleep time is longer, the deep sleep time is shorter, sleep score is lower (P<0.01); compared to the control group, CHD group has the higher incidence of coronary artery disease with OSAS (P<0.01), and coronary heart disease with mode-severe OSAS proportion also significantly higher than the control group (P< 0.05); compare their sleep quality was found in the merger of two different levels of OSAS patients with coronary heart disease, coronary heart disease with moderate to severe OSAS patients have a longer sleep time, longer entering sleep time and longer light sleep time, also have shorter deep sleep time, the total sleep scores is lower than normal-low mild OSAS patients (P<0.01, P<0.05); merge the same degree of OSAS CHD group and control group found that CHD with normal-mild OSAS group have lower sleep quality than the control group (P< 0.01); Based on the time to compare different degrees of OSAS patients with coronary heart disease sleep structure proportion, found that CHD with moderately severe OSAS group in HaiShi, ZiShi, ChouShi, YinShi have lower proportion of deep sleep scale and higher proportion light sleep scale (P< 0.01, P< 0.05); In haiShi, ZiShi, ChouShi, YinShi, MaoShi have a higher proportion of sleep apnea scale (P< 0.01). ③Based on the 12 two-hour periods of the day, analyze the parasympathetic nerve CHD group and the control group, found that parasympathetic nerve strength of CHD patients significantly decreased compared with the control group (P<0.01), which combined with mild sleep disorders of CHD patients parasympathetic intensity decreased more significantly (P<0.01). |
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