抑郁症及其亚型的睡眠脑电图研究

A study on sleep EEG in depression and its subtypes

目的探讨抑郁症患者睡眠脑电图的异常改变以及抑郁症不同亚型之间的差异。方法采用日本光电ＲＭ６０００多导生理记录仪，对１８例抑郁症患者和１９名健康人进行睡眠脑电图检查。结果与对照组比较，抑郁症组出现明显的醒觉时间增多、睡眠总时间减少、醒起时间增加、睡眠效率下降、睡眠维持率下降、第一阶段睡眠百分比增加、快速眼球运动（ＲＥＭ）潜伏期缩短和ＲＥＭ密度增加，经统计学处理差异均有显著性（Ｐ＜０．０５）。两组之间的其它指标比较，差异均无显著性（Ｐ＞０．０５）。精神病性抑郁患者较非精神病性抑郁患者的醒觉时间更长、睡眠总时间更短、睡眠维持率更低和慢波睡眠百分比明显减少，经统计学处理差异均有显著性（Ｐ＜０．０５）；其它指标与对照组间的差异均无显著性（Ｐ＞０．０５）。结论抑郁症患者除具有睡眠障碍在多导睡眠图的改变外，ＲＥＭ睡眠的活跃期提前是一个较为特征性的改变，精神病性患者与非精神病性抑郁患者两个亚型之间也存在一定的差异。

Objective The purpose of this study was to examine the abnormality of sleep EEG in depression and its various subtypes. Methods A sleep EEG study was carried out in 18 depressive patients and 19 normal controls. Results The depressive patients showed significantly prolonged awake time, reduced total sleep duration, increased early morning awakening, decreased sleep efficiency, reduced sleep maintenance, increased percentage of stage 1 sleep, shortened REM latency and increased REM density. Depressives with psychotic features significantly differed from those without psychotic features in that they had longer awakening duration, shorter total sleeping duration, worse sleeping maintenance, and lower percentage of slow wave sleep. Conclusion It suggests that the early appearance of REM sleep with increased REM activity could be a relatively specific marker in sleep changes in depression, and there are differences in sleep EEG changes between those with psychotic and non psychotic features.