Investigation On The Relationship Between Anxiety, Sleep, Symptoms And Signs At Different High Altitude Surroundings

Objective This study aimed to investigate the anxiety, sleep status, somatic symptomsand vital signs on young Chinese people exposed to high altitudes. And we sought toexplore the effects of anxiety on somatic symptoms and sleep status at high altitudes. Theexploration on the effects of unhealthy emotions on high altitudes symptoms, especially thesleeping status could enrich our theoretical fundamental on psychological intervention forplateau homework personnel.MethodsⅠ.The investigation on somatic symptoms, vital signs, anxiety and sleep status amongpopulation when ascended rapidlyWe marched along the groups with1505young Chinese males who will go to highaltitude for task assignment. Before departure, we collected baseline data on somaticsymptoms, vital signs, anxiety and sleep status. Self-made questionnaire were used tomeasure the somatic symptoms, portable fingertip oxygen instruments was used to recordthe heart rate and oxygen saturation, wrist sphygmomanometers were applied to measurethe blood pressure. The self-rating anxiety scale (SAS) was used to measure anxiety. Forsleeping status, the Athens insomnia scale (AIS) were used to assess the nocturnal sleepstatus, the Epworth sleepiness scale (ESS) was applied to evaluate the excessive daytimesleepiness. All the data were collected again at the day after the arrival of Lhasa (3700m)and at the6th day after arriving at Yangbajing (4400m). And we compared the differenceson somatic symptoms, sleep status and vital signs between anxiety ones and non-anxietyones. The factors which defined the anxiety occurrence were also explored. In thelongitudinal view, we surveyed the changes and prognosis of anxiety and sleep statusbetween anxiety ones and non-anxiety ones.Ⅱ.The investigation on somatic symptoms, vital signs, anxiety and sleep status onhigh altitude acclimated person. We followed and surveyed along with426young males who had acclimated at highaltitudes for40days. The somatic symptoms, vital signs, anxiety state(SAS),sleepstatus(AIS and ESS).The subjects began a journey last for13days, and the group arrivedat a destination with4400m in4hrs from3600m.And the data were collected for the secondtime the day after their arrival at4400m.We investigated the incidence of anxiety, insomniaand daytime sleepiness between the two high altitudes, a cross-sectional study was appliedfor investigating outcome of anxiety and sleep status at the two high altitudes in ourcross-sectional study. And we sought to find the risk factors accounting for anxietyoccurrence by binary logistic regression.Ⅲ. The investigationon anxiety, sleeping status, somatic symptoms, signs and theeffect of anxiety on other factors for the high altitude de-adaption population.For the population who had worked on the high altitude for3months in2011, wesurveyed their states on anxiety, sleeping disturbance, somatic symptoms, and signs40daysafter their return to the plain, and analyzed the difference of somatic symptoms, signs andsleeping status between anxiety and non-anxiety. Further we explored the correlationbetween AIS, demographical data, signs and psychological parameters.ResultsⅠ. The investigation on somatic symptoms, vital signs, anxiety and sleep status inrapid ascending populationThe anxiety incidence was4.2%(41/975)、15.2%(201/1325)and9.6%(62/646)respectively at500m,3700m and4400m,while the insomnia incidence was18.4%m(152/826)、42.7%(566/1325)and31.4%(203/646) respectively at the three altitudes, anddaytime sleepiness at the three altitudes was1.6%(219/1014)、41.7%(494/1184)and27.2%(163/596). According to the calssification of anxiety at the plain, we compared theirfollowing somatic symptoms, vital signs and sleep status at3700m, we found that,parameters (SAS, AIS, ESS, LLS and SBP) of anxiety ones were significantly higher thanthose of non-anxiety ones with HR slightly higher in comparison at3700m.Further in4400m, only LLS, SAS, AIS and ESS of anxiety ones were higher than those ofnon-anxiety ones. Analyzing anxiety and sleep status alteration in longitudinal view, wefound that, the one diagnosed as anxiety would not always presented as anxiety, and thecharacter of anxiety at plain could not predicate anxiety at high altitudes. Ⅱ. The investigation on anxiety, sleeping status, somatic symptoms, signs and thecorrelation between anxiety and other factorsAfter acclimation on the plateau for40days, we measured the anxiety, sleep status,questionnaires and other vital signs(HR, BP and SO2).The results demonstrated that,anxiety incidence at3600m,4400m were11.50%(49/426) and15.50%(51/329)respectively; and insomnia incidence was25.7%and27.1%respectively; daytimesleepiness incidence was41.5%and41.4%respectively. There was no significantlydifference between the psychological parameters at the two altitudes. AtYangbajing(3700m), incidence of somatic symptoms (headache, diziness, dazzle, tinitus,diahrea, constipation, abdomen distension, fatigue or weakness, difficulty sleep, reductionin activity, paresthesia, mental change, lethargy, cough, chest tightness, chest distress,palpitation) in anxiety group were significantly higher than those of non-anxiety group (allp<0.01). Only the incidence of GI in anxiety group was slightly higher than that ofnon-anxiety group (p<0.05). When at Yangbajing (4400m), incidences of all the symptomsamong anxiety group were higher than those of non-anxiety group. From3600m to4400m,the mean heart rate in subjects was elevated, while the mean oxygen saturation wasdecreased. The binary correlation analysis indicated that, anxiety was correlated with HR,AIS and ESS. Further, we found that, elevated heart rate (OR=2.432, p=0.023) and theAIS(OR=4.524，p<0.001) were the highest risk factors by binary logistic regressionanalysis.Ⅲ. The investigation on somatic symptoms, vital signs, anxiety and sleep status inhigh altitude de-acclimatization population.Anxiety ones account to12.26%(13/106) among the total subjects, and all the somaticsymptoms in anxiety group presented higher scores compared with non-anxiety group (allp<0.05), but there were no significantly difference in vital signs between the two groups.Analyzing the binary correlation between SAS and AIS, ESS, etc., there was a significantlypositive correlation between SAS and AIS (p <0.05).Conclusion1. Both anxiety and sleep disturbance were very common psychosomatic problems athigh altitudes. With altitude increased and acclimation period shorten, the incidence ofanxiety get higher, and so do the incidence of insomnia and daytime sleepiness. With the increasing acclimation period, anxiety and all the somatic discomforts would be relieved.Quick heart rate and insomnia were the important index of the occurrence of anxiety amongthe AMS subjects.2. The anxiety ones may present poorer somatic symptoms and more severe sleepdisturbance than the non-anxiety ones at high altitudes.3. Part of the participants don’t follow the rule that anxiety aggravates with altitudeincrease, i.e., the one who presented as anxiety would not always presented as anxiety, andthe portion of alleviation or aggravation is approximately equal, and those who werenon-anxiety may present as anxiety when asending.4. For the high altitude de-adaptation individuals, anxiety could still exist in someperson. And the anxiety ones would present poorer somatic symptoms than the non-anxietyones; nevertheless the occurrence of anxiety is always closely correlated with insomnia.