音乐疗法联合强光治疗对阿尔茨海默病患者睡眠障碍的疗效观察

doi:10.3969/j.issn.1006-7795.2021.03.005

首都医科大学学报 ›› 2021, Vol. 42 ›› Issue (3): 367-372.doi: 10.3969/j.issn.1006-7795.2021.03.005

音乐疗法联合强光治疗对阿尔茨海默病患者睡眠障碍的疗效观察

胡月青, 吕继辉^*, 王嫱, 马宗娟, 李文杰, 母海燕, 李沫, 高文超, 贾东梅

北京老年医院认知障碍诊疗中心,北京 100095

收稿日期:2021-03-17 出版日期:2021-06-21 发布日期:2021-06-16
通讯作者: *E-mail:lvjihui@139.com
基金资助:
首都卫生发展科研专项资助(2020-2-2191),北京老年医院“525”人才培养基金(2018-016)。

Efficacy of music therapy combined with bright light therapy on sleep disorders in patients with Alzheimer's disease

Hu Yueqing, Lyu Jihui^*, Wang Qiang, Ma Zongjuan, Li Wenjie, Mu Haiyan, Li Mo, Gao Wenchao, Jia Dongmei

Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing 100095, China

Received:2021-03-17 Online:2021-06-21 Published:2021-06-16
Contact: *E-mail:lvjihui@139.com
Supported by:
Capital's Funds for Health Improvement and Research (2020-2-2191),Beijing Geriatric Hospital “525” Talent Training Fund(2018-016).

摘要/Abstract

摘要： 目的探讨音乐疗法联合强光治疗对中、重度阿尔茨海默病(Alzheimer's disease, AD)患者睡眠障碍的临床疗效。方法将120例伴睡眠障碍的中、重度AD患者采用数字表法随机分为4组,即常规治疗组(对照组)、音乐组、强光组、联合治疗组,每组30例。4组患者均接受常规治疗,其中音乐组辅以睡前聆听舒缓音乐,强光组辅以上午强光照射,联合治疗组同期辅以音乐疗法和强光治疗。4组患者治疗前、连续治疗4周后均接受匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)评估。该量表得分越高,提示睡眠障碍越严重。结果治疗前4组患者基线资料、PSQI总分及各成分得分组间差异无统计学意义(P＞0.05)。治疗前后差值的组间比较,联合治疗组催眠药物得分下降程度高于强光组,差异有统计学意义(P＜0.05),而PSQI总分及其他成分得分差值组间比较,差异无统计学意义(P＞0.05);联合治疗组与强光组在PSQI总分、睡眠质量、入睡时间、睡眠效率及日间功能的得分值下降较音乐组和对照组明显,音乐组PSQI总分及催眠药物得分较对照组下降明显,差异均有统计学意义(P＜0.05)。结论对伴随睡眠障碍的中、重度AD患者在常规治疗的基础上辅以音乐疗法联合强光治疗,可以有效改善其整体睡眠质量;单纯音乐疗法或强光治疗仅对中、重度AD患者睡眠障碍的某些成分有效。

关键词: 阿尔茨海默病, 睡眠障碍, 音乐疗法, 强光治疗

Abstract: Objective To explore the effect of combination therapy with music therapy (MT) and bright light therapy (BLT) on sleep disorders in patients with moderate-severe Alzheimer's disease (AD). Methods A total of 120 patients with moderate or severe AD accompanied with sleep disorders were randomly divided into 4 groups: routine therapy group (control group), MT group, BLT group, and combination therapy group. All patients in the 4 groups received routine treatment. Besides listening to soothing music for 30 minutes before bedtime was supplemented to the MT group, while bright light exposure in the morning for 30 minutes was supplemented to the BLT group; Both MT and BLT were performed in the combination therapy group. The Pittsburgh Sleep Quality Index (PSQI) was evaluated before and after the intervention which lasted for 4 consecutive weeks. Results The baseline characteristics, scores of PSQI and its subscores had no significant difference in the pre-intervention assessment among 4 groups (P>0.05). In the comparison of the difference between pre- and post-intervention, the decrease of the score of sleep medication in the combination therapy group was higher than that in the BLT group, with a statistically significant difference (P<0.05), while in the comparison of the PSQI total score and the scores of other components between the two groups, the difference was not statistically significant (P>0.05). However, the scores of PSQI, sleep quality, sleep latency, sleep efficacy and daytime dysfunction in the combination therapy group and BLT group decreased more significantly than those in the MT group and the control group (P<0.05). The score of PSQI and sleep medication in the MT group decreased significantly compared with the control group, and the differences were both statistically significant (P<0.05). Conclusion The routine treatment supplemented by MT in combination with BLT can effectively improve the overall sleep quality for patients with moderate or severe AD accompanied with sleep disorders, but MT or BLT alone is only effective for certain components of sleep disorders.

Key words: Alzheimer's disease, sleep disorders, music therapy, bright light therapy

中图分类号:

R749.1

胡月青, 吕继辉, 王嫱, 马宗娟, 李文杰, 母海燕, 李沫, 高文超, 贾东梅. 音乐疗法联合强光治疗对阿尔茨海默病患者睡眠障碍的疗效观察[J]. 首都医科大学学报, 2021, 42(3): 367-372.

Hu Yueqing, Lyu Jihui, Wang Qiang, Ma Zongjuan, Li Wenjie, Mu Haiyan, Li Mo, Gao Wenchao, Jia Dongmei. Efficacy of music therapy combined with bright light therapy on sleep disorders in patients with Alzheimer's disease[J]. Journal of Capital Medical University, 2021, 42(3): 367-372.

参考文献

[1] Wang C, Holtzman D M.Bidirectional relationship between sleep and alzheimer's disease:Role of amyloid, tau, and other factors[J].Neuropsychopharmacol, 2019,45(474):1-17.
[2] Kinnunen K M, Vikhanova A, Livingston G, et al.The management of sleep disorders in dementia:an update[J].Curr Opin Psychiatry, 2017,30(6):491-497.
[3] Jennum P , Cano J S , Bassetti C,et al.Sleep disorders in neurodegenerative disorders and stroke[M].Sleep disorders in neurodegenerative disorders and stroke.New Jersey Wiley:Blackwell Publishing Ltd, 2011,1:529-543.
[4] O'Caoimh R, Mannion H, Sezgin D, et al.Non-pharmacological treatments for sleep disturbance in mild cognitive impairment and dementia:A systematic review and meta-analysis[J].Maturitas, 2019,127:82-94.
[5] Roccaro I, Smirni D.Fiat lux:The light became therapy.An overview on the bright light therapy in alzheimer's disease sleep disorders[J].J Alzheimers Dis, 2020, 77(1):113-125.
[6] 丁燕, 陆志德, 张海霞.古琴音乐疗法对轻中度阿尔茨海默病患者睡眠影响的研究[J].齐齐哈尔医学院学报, 2019,40(14):1754-1755.
[7] Cohen D A.Therapy in Sleep Medicine[M].Sleep disorders associated with dementia.Philadelphia:Saunders, 2012,3:656-665.
[8] Rust J.Updating the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)[J].Health Inf Manag, 2010, 39(2):40.
[9] Association A P.Diagnostic and statistical manual of mental disorders (dsm-iv-tr)[M].Washington D C, USA:American Psychiatric Association, 2000:495-497.
[10] Salami O, Lyketsos C, Rao V.Treatment of sleep disturbance in Alzheimer's dementia[J].Int J Geriatr Psych, 2011,26(8):771-782.
[11] 蹇正清, 刘静, 夏昌华, 等.积极音乐疗法对老年痴呆患者睡眠障碍的影响[J].山西医药杂志(下半月刊), 2013,42(9):1069-1071.
[12] Tatiana-Danai D, Magda T.Evaluation of the efficacy of randomized controlled trials of sensory stimulation interventions for sleeping disturbances in patients with dementia:A systematic review[J].Clin Interv Aging, 2017,12:543-548.
[13] Toh K L.Basic science review on circadian rhythm biology and circadian sleep disorders[J].Ann Acad Med Singap, 2008,37(8):662-668.
[14] Faulkner S M, Bee P E, Meyer N, et al.Light therapies to improve sleep in intrinsic circadian rhythm sleep disorders and neuro-psychiatric illness:Sleep Med Rev, 2019, 46:108-123.
[15] Shouse M N, Staba R J, Saquib S F, et al.Monoamines and sleep:Microdialysis findings in pons and amygdala[J].Brain Res, 2000,860(1):181-189.
[16] Trillo L, Das D, Hsieh W, et al.Ascending monoaminergic systems alterations in Alzheimer's disease.Translating basic science into clinical care[J].Neurosci Biobehav Rev, 2013,37(8):1363-1379.
[17] Roh J H, Huang Y, Bero A W, et al.Disruption of the sleep-wake cycle and diurnal fluctuation of β-amyloid in mice with alzheimer's disease pathology[J].Sci Transl Med, 2012,4(150):150ra122.

音乐疗法联合强光治疗对阿尔茨海默病患者睡眠障碍的疗效观察

Efficacy of music therapy combined with bright light therapy on sleep disorders in patients with Alzheimer's disease

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	孟霞, 李梦, 王晶晶, 张静, 陈柏安, 卢静. 5xFAD转基因小鼠与阿尔茨海默病患者大脑中β-淀粉样蛋白特征的异同[J]. 首都医科大学学报, 2022, 43(1): 106-112.
[2]	马登磊, 李延峥, 祝艳秋, 李林, 张兰. 山茱萸环烯醚萜苷对快速老化小鼠行为学及病理学改变的影响[J]. 首都医科大学学报, 2021, 42(5): 754-760.
[3]	林雪霏, 吴楠, 张海萍. 多汗症患者焦虑抑郁状态及睡眠情况研究[J]. 首都医科大学学报, 2021, 42(5): 841-846.
[4]	詹敏敏, 马慧萱, 康雪纯, 鲁新亮, 宫淑婷, 邹琦, 吕继辉, 周爱红, 贾建平, 魏翠柏. 轻中度阿尔茨海默病患者精神行为学症状特点及关联性分析[J]. 首都医科大学学报, 2021, 42(3): 354-359.
[5]	郝淑文, 陈瑛, 丁晖, 赵春松, 梁阔, 薛金花, 蔡彦宁. 阿尔茨海默病、轻度认知功能障碍及主观认知下降患者血液DNA中多个基因的甲基化分析[J]. 首都医科大学学报, 2021, 42(3): 447-452.
[6]	李妍. 守护“记忆之魂”的中国痴呆临床研究引领者——贾建平教授[J]. 首都医科大学学报, 2020, 41(5): 822-827.
[7]	杨翠翠, 包训杰, 张丽, 李雅莉, 李林, 张兰. 7月龄及16月龄APP/PS1/tau三转基因小鼠脑内突触相关蛋白的变化及山茱萸环烯醚萜苷的影响[J]. 首都医科大学学报, 2020, 41(3): 391-396.
[8]	刘玉莲, 贾竑晓, 宋楠, 姚昊, 宁艳哲. 倒班工作睡眠障碍患者的注意网络功能研究[J]. 首都医科大学学报, 2020, 41(1): 71-74.
[9]	杨翠翠, 包训杰, 张丽, 李雅莉, 李林, 张兰. 山茱萸环烯醚萜苷对APP/PS1/Tau三转基因小鼠脑内病理变化的影响[J]. 首都医科大学学报, 2019, 40(4): 588-595.
[10]	唐煜, 郝单单, 秦玮婷, 文潇, 李放. 轻度阿尔茨海默病患者年龄对蒙特利尔认知评估量表基本版得分的影响[J]. 首都医科大学学报, 2019, 40(4): 652-655.
[11]	樊响, 杨延辉, 贾秀琴, 卢洁, 李坤成. 轻度认知障碍静息态功能磁共振研究低频振幅分析[J]. 首都医科大学学报, 2018, 39(2): 163-166.
[12]	金贺, 赵志炜, 王蓉. 追赶生长与阿尔茨海默病相关性[J]. 首都医科大学学报, 2017, 38(6): 831-834.
[13]	尹晓敏, 徐婷, 戴伍飞, 钱嘉逸, 陈晨, 张兰, 李林. 二苯乙烯苷对神经细胞淀粉样肽前体蛋白表达的影响及其与CREB调节相关的作用机制[J]. 首都医科大学学报, 2017, 38(6): 835-840.
[14]	李雪莲, 杨翠翠, 张兰, 石京山. 山茱萸环烯醚萜苷对蛋白磷酸酶2A催化亚基C磷酸化的调节机制[J]. 首都医科大学学报, 2016, 37(6): 777-783.
[15]	杨翠翠, 李林, 张丽, 李雅莉, 张兰. 马钱苷通过抑制蛋白磷酸酶2A催化亚基C磷酸化降低tau蛋白过度磷酸化[J]. 首都医科大学学报, 2016, 37(6): 789-793.