以失眠或嗜睡为主诉抑郁障碍患者睡眠特征比较研究

A comparative study on sleep characteristics of depressive disorder patients with insomnia or sleepiness as the complaint

目的分析以失眠为主诉的抑郁障碍和以嗜睡为主诉的抑郁障碍患者睡眠特征。方法收集抑郁障碍患者102例,行整夜多导睡眠监测,并完成匹兹堡睡眠质量指数量表、抑郁自评量表、焦虑自评量表、Epworth嗜睡量表评估。根据量表结果,将患者分为以失眠为主诉的抑郁障碍(the depressive disorder with insomnia as the complaint,DDI)组(59例)和以嗜睡为主诉的抑郁障碍(the depressive disorder with sleepiness as the complaint,DDS)组(43例)。结果两组患者的睡眠结构均不同程度紊乱,表现为睡眠效率下降、非快速眼动睡眠1期(N1)比例增加,非快速眼动睡眠3期(N3)和快速眼动睡眠(rapid eye movement,REM)比例减少。与DDS组相比,DDI组的睡眠效率较低、N1期比例较高、N3期比例较低(P<0.05)。而在REM睡眠潜伏期上DDS组比DDI组延长(P<0.05)。相对于DDS组,DDI组的睡后觉醒时间及其占总睡眠时间百分比高,而觉醒次数少(P<0.05)。相关分析显示年龄与组间有差异的睡眠参数存在相关(P<0.05)。而控制年龄因素后两组睡眠参数的差异基本无统计学意义(P>0.05)。结论DDI与DDS患者的睡眠参数存在差异,控制年龄因素后这种差异消失,提示年龄因素对抑郁障碍的睡眠参数影响可能更为显著。

Objective To analyze the sleep characteristics of depressive disorder patients with insomnia as the complaint and those with sleepiness as the complaint.Methods One hundred and two patients with depressive disorder were recruited.All subjects underwent polysomnography throughout one night and completed the Pittsburgh Sleep Quality Index,Self-rating Depression Scale,Self-rating Anxiety Scale and Epworth Sleepiness Scale.According to the results of the scales,the patients were divided into the depressive disorder with insomnia as the complaint group(DDI,59 cases)and the depressive disorder with sleepiness as the complaint group(DDS,43 cases).Results The two groups showed different degree of sleep structure disorder,manifested as decreased sleep efficiency,increased proportion of non-rapid eye movement sleep stage 1(N1),and decreased proportion of non-rapid eye movement sleep stage 3(N3)and rapid eye movement sleep phase(REM).In comparison with the DDS group,the DDI group had lower sleep efficiency and proportion of N3 stage,higher proportion of N1 stage(P<0.05).The DDS group had longer REM sleep latency than the DDI group(P<0.05).Compared with the DDS group,the DDI group had higher wake time after sleep onset and the percentage of total sleep time(P<0.05),and fewer number of awakenings(P<0.05).Correlation analysis showed that there was a correlation between age and sleep parameters that differed between the groups(P<0.05).However,the difference in sleep parameters between the two groups was no longer significant after controlling for age(P>0.05).Conclusions There was some differences in sleep parameters between the DDI and DDS groups.After controlling the age factor,the difference was no longer significant,suggesting that the age factor may have a more significant impact on the sleep parameters of depressive disorder.