Étude des troubles du sommeil et de la vigilance chez les patients consultant pour un malaise en médecine générale

Sleep disorders, excessive daytime sleepiness and malaises are frequent among patients of general practitioners. We studied sleep and sleepiness disorders in patients complaining of malaise in medical general practice compared to control patients with another complaint. For this purpose, we performed a prospective case study over 8 months, using the Pittsburgh Quality Sleep Index (PQSI) and the Epworth Sleepiness Scale (ESS) to measure sleep quality and daytime sleepiness, respectively. We analyzed 92 questionnaires, 43 from patients reporting malaise and 49 from a control group. The malaise group displays a significantly lower sleep quality than the control group: 72% of malaise patients have a PQSI score > 5 (versus 41% in the control group). In addition, the malaise patients suffer a significant increase in daytime sleepiness (average ESS score 8,60 ± 3,54 versus 6,23 ± 3,97 in the control group). Those with a cardiovascular malaise have poor sleep quality, excessive daytime sleepiness and an average sleep duration below 7 h. In these patients, one should consider investigating the obstructive sleep apnoeas. Those with a psychogenic malaise suffer from anxiety and hypervigilance, take sleeping pills. One should look for insomnia in these patients. General practitioners should explore sleep disorders in patients reporting malaise, in particular possible obstructive sleep apnoea in the case of a cardiovascular malaise and insomnia in the case of a psychogenic malaise.