抑郁症共病睡眠呼吸暂停患者睡眠结构特点及其影响因素

Sleep structure features of depression patients with sleep apnea and its influencing factors

目的探讨抑郁症共病睡眠呼吸暂停患者睡眠结构特点。方法选择抑郁症共病睡眠呼吸暂停患者70例设为研究组，抑郁症患者70例设为对照组。采用一般情况问卷、汉密顿焦虑量表、汉密顿抑郁量表评定焦虑、抑郁症状，采用多导睡眠记录仪监测整夜睡眠。结果研究组患者汉密顿抑郁量表焦虑／躯体化、迟缓、睡眠障碍因子分及汉密顿焦虑量表总分、躯体性焦虑因子分显著高于对照组（P〈0．05或0．01）。研究组患者睡眠效率显著低与对照组（P〈0．05），睡眠潜伏期、Ⅲ期睡眠、快速动眼睡眠时间及次数显著少于对照组（P〈0．05或0．01），快速动眼睡眠潜伏期、Ⅰ期睡眠时间显著多于对照组（P〈0．05或0．01）。研究组汉密顿抑郁量表睡眠障碍因子分与快速动眼睡眠时间呈显著正相关（P〈0．01），与快速动眼睡眠潜伏期呈显著负相关（P〈0．01），汉密顿抑郁量表总分和绝望感因子分与快速动眼睡眠潜伏期呈显著负相关（P〈0．05）。研究组汉密顿焦虑量表总分、躯体性焦虑和精神病性焦虑因子分均与快速动眼睡眠时间呈显著正相关（P〈0．01）。研究组睡眠呼吸暂停低通气指数指数与体质最指数，汉密顿抑郁量表焦虑／躯体化、认识障碍及日夜变化因子分呈显著正相关（P〈0．01）。结论抑郁症共病睡眠呼吸暂停者睡眠结构紊乱更明显，睡眠呼吸暂停与焦虑、抑郁症状严重程度相关。

Objective To investigate the sleep structure features of depression patients with sleep apnea. Methods 70 depression patients with sleep apnea were selected as observation group, 70 depression patients were selected as control group. Anxiety and depression symptoms were evaluated by general situation questionnaire, HAMA, HAMD, sleep over night was monitored by polysomnography. Results Fac tors score of HAMD anxiety/ somatization, slow, sleep disorder and HAMA total score, somatic anxiety factor score of observation group were higher than control group （P〈0.05 or 0.01）. Sleep efficiency of observation group was significantly lower than control group （P〈0.05）, REM latency, phase Ⅲ sleep, REM sleep time and frequency were significantly lower than control group （P〈0.05 or 0.01 ）, REM sleep latency, phase Ⅰ sleep time were significantly higher than control group （P〈0.05 or 0.01）. HAMD sleep disorders factor score of observation group was positively correlated with REM sleep time （P〈0.01）, and negatively correlated with REM sleep latency （P%0.01）, HAMD total score and despair factor score were negatively correlated with REM sleep latency （P〈0.05）. HAMA total score, somatic anxiety and psycho- pathic anxiety factor score of observation group were positively correlated with REM sleep time （P 〈 0.01）. Apnea-hypopnea index and body mass index, HAMD anxiety/ somatization, cognition disorders, circadian changes factor in observation group were positively correlated （P〈0.01）. Conclusion Depression patients with sleep apnea have inordinate sleep structure, sleep apnea is correlated with anxiety, depressive symptom.