夜间缺氧对老年抑郁症客观睡眠及临床症状的影响

Effect of nocturnal hypoxia on objective sleep and clinical symptoms in senile depression

目的:探讨伴与不伴有阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的老年抑郁症患者的客观睡眠,探讨夜间缺氧对老年抑郁症患者客观睡眠和临床症状的影响。方法:35例伴OSAHS的老年抑郁症患者为观察组,40例无OSAHS的老年抑郁症患者为对照组,两组均行多导睡眠监测(PSG)。采用汉密尔顿抑郁量表(HAMD-24)评估两组的临床症状。结果:观察组患者总睡眠时间(TST)、睡眠效率(SE)短于对照组,差异有统计学意义(P<0.05);观察组患者非快眼动睡眠1期比例(N1%)长于对照组,非快眼动睡眠2期时间(N2)、快眼动睡眠期时间(REM)、快眼动睡眠期比例(REM%)短于对照组,差异有统计学意义(P<0.05);观察组患者HAMD评分高于对照组,差异有统计学意义(P<0.001);相关分析显示,观察组患者HAMD总分与TST、SE、N2时间及平均血氧饱和度呈负相关,差异有统计学意义(P<0.05)。结论:夜间缺氧对老年抑郁症患者的客观睡眠及临床症状均有影响,表现在TST、SE缩短,N1比例增加,N2时间、REM时间和比例均变短,有夜间缺氧的老年抑郁症患者临床症状更严重,且与总睡眠时间、N2时间、睡眠效率、平均血氧饱和度呈负相关。

Objective:To investigate the effect of nocturnal hypoxia on objective sleep and clinical symptoms in senile patients with depression combined with and without obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:Thirty-five patients with senile depression complicated with OSAHS were the observation group,and 40 patients with senile depression without OSAHS were the control group.Both groups received polysomnography(PSG).Hamilton Depression Scale(HAMD-24)was used to evaluate the clinical symptoms of both groups.Results:The total sleep time(TST)and sleep efficiency(SE)of the observation group were shorter than those of the control group,and the difference was statistically significant(P<0.05).The proportion of non-REM sleep phase 1(N1%)in the observation group was longer than that in the control group,while the proportion of non-REM sleep phase 2(N2),REM sleep phase(REM%)was shorter than that in the control group,and the difference was statistically significant(P<0.05).The HAMD score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.001).Correlation analysis showed that HAMD total score was negatively correlated with TST,SE,N2 time and average blood oxygen saturation in the observation group,with statistical significance(P<0.05).Conclusion:Nocturnal hypoxia has an impact on objective sleep and clinical symptoms of senile patients with depression,which is manifested in shortening TST and SE,increasing the proportion of N1,and shortening the time of N2,REM time and proportion.The clinical symptoms were more severe in senile depression with nocturnal hypoxia,and were negatively correlated with total sleep time,N2 time,sleep efficiency and mean blood oxygen saturation.