抑郁症病人睡眠结构特征与前瞻性记忆的相关性研究

The correlation between sleep structure characteristics and prospective memory in patients with depression

目的 探讨抑郁症病人睡眠结构特征及其与前瞻性记忆的相关性。方法 选取2017年1月至2020年1月安徽省精神卫生中心113例住院抑郁症病人作为抑郁组,同期该中心公开招募47例健康者作为对照组,两组对象均行多导睡眠监测,评估汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆(TBPM),分析抑郁症病人睡眠结构与EBPM和TBPM的关系。结果 相比于对照组,抑郁组快速眼动睡眠(REM)潜伏期(235.52±83.65)min和卧床时间507.00(49.25)min较对照组REM潜伏期(137.78±56.23)min和卧床时间483.80(54.50)min长(P<0.05);抑郁组EBPM评分2.00(5.00)分和TBPM评分2.00(4.00)分较对照组的EBPM 6.00(5.00)分和TBPM 5.00(5.00)分少(P<0.05)。相关性分析显示,抑郁组N2潜伏期与TBPM呈正相关[β=0.041,95%CI:(0.008,0.074)],REM持续时间与TBPM呈正相关[β=0.024,95%CI:(0.010,0.039)]。模型加入性别、年龄、文化、体质量指数(BMI)、HAMD、HAMA、病程等混杂因素后,多因素线性回归分析结果显示,抑郁组REM持续时间仍与TBPM呈正相关[β=0.017,95%CI:(0.003,0.031)];而N2潜伏期与TBPM的关联差异无统计学意义(P>0.05)。结论 抑郁症病人存在睡眠结构异常和前瞻性记忆损害,TBPM与REM持续时间呈正相关,且这种关联不受病人性别、年龄、文化、体质量指数、抑郁程度、焦虑程度和病程等的影响。

Objective To explore the structural sleep characteristics of depressed patients and their correlation with prospective memory.Methods A total of 113 hospitalized depressed patients from January 2017 to January 2020 at Anhui Provincial Mental Health Center were selected as the depression group,and 47 healthy individuals were openly recruited as the control group during the same period.The subjects in both groups underwent polysomnography to assess the Hamilton Depression Scale(HAMD),Hamilton Anxiety Inventory(HAMA),event-based prospective memory(EBPM),and time-based prospective memory(TBPM),and the relationship between sleep structure and EBPM and TBPM in depressed patients was analyzed.Results The rapid eye movement(REM) sleep incubation period [(235.52±83.65) min] and bedtime(TIB) [507.00(49.25) min] were longer in the depressed group than in the control group for the REM sleep incubation period [(137.78±56.23) min] and TIB [483.80(54.50) min](P<0.05).The EBPM score [2.00(5.00)points] and TBPM score [2.00(4.00) points] in the depressed group were lower than those in the control group(EBPM [6.00(5.00)points] and TBPM [5.00(5.00) points])(P<0.05).Correlation analysis showed that the N2 incubation period in the depression group was positively correlated with TBPM [β=0.041,95%CI:(0.008,0.074)] and REM duration was positively correlated with TBPM [β=0.024,95%CI:(0.010,0.039)].After adding confounders such as sex,age,culture,body mass index(BMI),HAMD,HAMA,and duration of illness to the model,multivariate linear regression analysis showed that REM duration remained positively correlated with TBPM in the depression group [β=0.017,95%CI:(0.003,0.031)],while the difference between the association of N2 latency and TBPM was not statistically significant(P>0.05).Conclusions Depressed patients had abnormal sleep structure and prospective memory impairment,and TBPM was positively associated with REM duration.This association was not affected by patient gender,age,culture,body mass index,depression level,anxiety level,or disease duration.