复发抑郁症患者的主客观睡眠差异及相关因素

Differences between subjective and objective sleep quality in recurrent depressive patients and the correlative factors

目的:探讨复发抑郁症患者的主客观睡眠质量差异及分析相关因素。方法:收集符合纳入标准的复发抑郁症(复发组)及首发抑郁症(对照组)患者各32例,使用匹茨堡睡眠质量指数量表评估主观睡眠质量,汉密尔顿焦虑抑郁量表评估焦虑抑郁情绪,多导睡眠监测仪监测客观睡眠质量。结果:主观睡眠方面,复发组较对照组总睡眠时间缩短,睡眠潜伏期延长,睡眠效率降低;客观睡眠方面,复发组较对照组清醒次数增多、NREM1期延长、NREM2期缩短、REM期睡眠时相延长、REM期比例增加、REM期潜伏期缩短;两组间差异有统计学意义(P<0.05)。复发组及对照组两组组内均存在明显主客观睡眠差异,复发组主客观睡眠差异更加明显,差异均有统计学意义(P<0.01)。复发组的总睡眠时间主客观差值与PSQI总分、病程、发作次数呈正相关(P<0.05),睡眠潜伏期差值及睡眠效率差值均与PSQI总分、HAMA-14总分呈正相关(P<0.05)。结论:复发抑郁症患者的主客观睡眠质量之间存在明显差异,且主客观睡眠差异与病程、发作次数、PSQI总分、HAMA-14总分间存在相关性。

Objective To investigate the differences between subjective and objective sleep quality in recurrent depressive patients and the correlative factors. Methods Thirty-two cases of recurrent depressive patients （the recurrent group） and 32 cases of first episode depressive patients （the control group） who met the inclusion were recruited in this study. The subjectivesleep quality, mood and objective sleep quality of patients were estimated by Pittsburgh sleep quality index （PSQI）, Hamilton anxiety Scale （HAMA）, Hamilton depression Scale （HAMD） , respectively. One whole-night polysomnography （PSG） was recorded. Results On subjec- tivesleep quality, the total sleep time was shorter, the sleep latency was longer, and the sleep efficiency was lower in the recurrent group compared with the control group. On objectivesleep quality, the wake times were increased, the NREM1 phase was longer, the NREM2 phase was shorter, the RME phase was longer, the proportion of REM phase was increased, and the latency of REM phase was shorter in the recurrent group compared with the control group （P 〈 0.05, respectively）. There were significant differences between the subjective and objective sleep quali- ty in both groups, while the differences in the recurrent group were more significant （P 〈 0.01 ）. In the recurrent group, thedifference of the total time between the subjective and objective sleep was positively correlated with PSQI score, the duration of disease and the number of attacks （P 〈 0.05）, while, the differences of the sleep latency and sleep efficiency between the subjective and objective sleep were both positively correlated withPSQI score and the HAMA-14 score, respectively （P 〈 0.05）. Conclusion There was a significant difference between the subjective and objective sleep quality of patients with recurrent depression, and the differences were related to the course of disease, the number of attack, PSQI score and HAMA-14 score.