Correlation Between Sleep Characteristics Of Insomnia And TCM Syndromes In The Elderly

BackgroundWith the acceleration of the aging of the population,people are increasingly concerned about the physical and mental health of the elderly.It is estimated that at present,about 40%to 70%of the elderly people have different types and different degrees of sleep disorder[1],and chronic insomnia accounts for the largest proportion of all types of sleep disorders.Long term insomnia will not only cause many negative effects on human physiology and psychology,but also lead to a decline in daytime wakefulness.It is mainly manifested in the symptoms of daytime sleepiness,frequent dozing,fatigue,indifference,loss of interest in past interest,concentration of attention,cognitive impairarment,etc.[2],but the research on whether there is daytime sleepiness in insomniacs has not yet been found at present.A consistent conclusion.In addition,in clinical practice,it is found that insomnia is mostly caused by psychological,emotional and mental factors in young people,and the clinical manifestations are often difficult to fall asleep,but for the elderly,with the decline of the function of the viscera,whether the structure of the sleep is different from the young and other types of insomnia,there is less research on the type of insomnia in the elderly,which is worth further deepening.Enter into inquiry.At present,western medicine mainly uses sedative hypnotic drugs to treat insomnia,although it can achieve a certain effect,but it is easy to produce drug dependence and addiction for a long time.In comparison,traditional Chinese medicine has made an individualized treatment plan through the treatment of syndrome differentiation.The clinical effect is remarkable,and the adverse reactions such as drug dependence and tolerance will not be produced for a long time.Therefore,to explore the sleep characteristics of the elderly,the sleep characteristics and the association of TCM syndromes will help to choose a more reasonable treatment method,which is of great significance to the improvement of the quality of life of the elderly and the relief of the burden of the society.ObjectiveThrough the investigation of the general data of the elderly insomniacs,the characteristics of sleep(mainly including the type of insomnia,the degree of daytime awakening),the distribution law of TCM syndromes,the difference between PSQI and ESS in the type of insomnia and TCM syndromes,the correlation between the type of insomnia and TCM syndromes,provide a reference for the treatment of insomnia and prevention and health care for the elderly.MethodsAccording to the diagnostic standard of Chinese mental disorder classification and diagnostic standard(CCMD-3),145 elderly insomniacs were randomly included in the diagnosis standard of insomnia.The general data of the patients and four diagnosis information of TCM were collected,the number of Pittsburgh sleep finger(PSQI),Epworth sleepiness(ESS)and SPIEGEL sleep scale were scored,and the type of insomnia and TCM syndromes were determined.SPSS20.0 statistical analysis software was used to analyze the collected data,the corresponding selection descriptive analysis,rank sum test,logistic stepwise regression analysis and other statistical analysis methods.Results1 general data:the elderly insomniacs,104(71.7%)women(71.7%),41 men(28.3%),female patients more than men,73 cases of mental workers(50.3%),39 physical labourers(26.9%),and 33(22.8%)physical mental labor in the occupational difference.Most elderly insomniacs have a long course of disease,mainly concentrated in more than 5 years,a total of 78 cases(53.8%);most elderly patients with insomnia with other systemic diseases,a total of 126 cases(86.9%);53.1%of patients with continuous use or intermittent use of sedative hypnotic drugs.2 The distribution of TCM syndromes of elderly insomniacs from many to less were 52 cases of insufficiency of heart and spleen(35.9%),39 cases of fire excess from yin deficiency(26.9%),25 cases of Yang Qi deficiency(17.2%),16 cases of type of phlegm-heat attacking the heart(10.3%),13 cases of Liver fire harassing the heart(9.7%).3 The types of insomnia of the elderly insomniacs diagnosed from many to less were 41 cases of mixed type(28.3%),35 cases of sleep fragmentation(24.1%),24 cases of difficulty in falling asleep(16.6%),20 cases of early awakening(13.8%),15 cases of dreaminess(10.3%),and 10 cases of pernoctation(6.9%).4 The PSQI score of the elderly insomniacs was mainly between 14-17 points,78 cases(53.8%),and the ESS scale score of 143 cases(98.6%).5 The PSQI score of the elderly insomniacs was distributed between the TCM syndromes,and the rank sum test was P=0.464>0.05,and there was no statistical difference.6 The PSQI score of the elderly insomniacs was distributed between the types of insomnia,and the rank sum test was P=0.037<0.05,and the difference was statistically significant.The mean values of the type of difficulty in falling asleep,the type of sleep fragmentation,the type of dreaminess,the type of early awakening,the type of pernoctation,and the mixed type were 14.33,13.63,15.60,14.15,15.30 and 15.56 respectively.7 The relationship between the type of insomnia of the elderly insomniacs and TCM syndromes,the logistic stepwise regression analysis showed that the type of difficulty in falling asleep was positively related to fire excess from yin deficiency(P=0.020<0.05,OR value was 3.000>1).There was a positive correlation between the type of sleep fragmentation and insufficiency of heart and spleen(P=0.044<0.05,OR value 2.091>1),there was a positive correlation between the type of early awakening and the deficiency of Yang Qi(P=0.033<0.05,OR value is 3.000>1).Conclusion1 Elderly patients with insomnia are characterized by high incidence of women.Mental workers are more likely to suffer from insomnia.2 The distribution of TCM syndromes in elderly patients with insomnia was mainly asthenia syndrome,mainly for two deficiency of heart and spleen,yin deficiency and fire.3 The most common type of insomnia in elderly patients is mixed type,followed by early a.wakening.4 The sleep quality of elderly patients with insomnia is poor,but the incidence of daytime sleepiness is small.5 There is no correlation between TCM syndromes and sleep quality in elderly patients with insomnia.6 The type of insomnia in elderly people is related to sleep quality.the type of dreaminess,the mixed type and the type of pernoctation is the worst.7 There is a certain correlation between the types of insomnia in the elderly insomniacs and TCM syndromes.The insomnia of difficulty in falling asleep is mostly seen in the syndrome of fire excess from yin deficiency,the insomnia of sleep fragmentation is mostly seen in the syndrome of insufficiency of heart and spleen,the insomnia of early awakening is mostly seen in the syndrome of the deficiency of Yang Qi.