老年女性抑郁症患者客观睡眠特征和自杀意念的相关性研究

Correlation studies of objective sleep characteristics and suicidal ideation in elderly female patients with depression

目的 探讨老年女性抑郁症患者客观睡眠特征和自杀意念的相关性。方法 采用方便抽样法,选取2019年4月至2021年12月在安徽省精神卫生中心住院的128例老年女性抑郁症患者为研究对象。根据汉密尔顿抑郁量表(HAMD)第3个条目得分将患者分为有自杀意念组(n=81)和非自杀意念组(n=47)。采用多导睡眠监测评估患者的总睡眠时间、睡眠潜伏期、睡眠效率、快速眼动睡眠潜伏期(REML)、觉醒次数、觉醒总时间、非快速眼动睡眠在各阶段睡眠(N1、N2、N3期)时间、快速眼动睡眠期。比较两组患者的一般资料、抑郁症状严重程度和客观睡眠特征。采用二项Logistic回归分析老年女性抑郁症患者客观睡眠特征与自杀意念的关系。结果 单因素分析结果显示,两组患者的职业类别、HAMD得分、睡眠效率、总睡眠时间、觉醒总时间、觉醒次数、N1期睡眠时间、N2期睡眠时间、N3期睡眠时间、REML比较,差异有统计学意义(P<0.05)。二项Logistic回归分析显示,在控制了职业类别和抑郁症状严重程度后,睡眠效率(OR=0.857,95%CI=0.748~0.983)、总睡眠时间(OR=0.971,95%CI=0.947~0.996)、觉醒次数(OR=1.092,95%CI=1.005~1.188)、N1期睡眠时间(OR=1.059,95%CI=1.018~1.101)、N3期睡眠时间(OR=0.976,95%CI=0.956~0.996)是老年女性抑郁症患者自杀意念的影响因素(P<0.05)。结论 老年女性抑郁症患者客观睡眠特征中的睡眠效率降低、睡眠时间减少、觉醒次数增加、N1期睡眠时间延长、N3期睡眠时间减少,导致患者更容易产生自杀意念。

Objective To investigate the correlation between objective sleep characteristics and suicidal ideation.Methods A total of 128 elderly female patients with depression who were hospitalized at the Anhui Mental Health Centre from February 2019 to December 2021 were selected as study subjects by the convenience sampling method.They were divided into the suicidal ideation group(n=81)and the non-suicidal ideation group(n=47),according to the score of Item 3 in the Hamilton Depression Scale(HAMD).The total sleep time,sleep latency,sleep efficiency,rapid eye movement sleep latency(REML),awakening times,total awakening time,non-rapid eye movement sleep sleep time in different stages(N1,N2,N3),and rapid eye movement sleep were evaluated by polysomnography.The general information,severity of depressive symptoms,and objective sleep characteristics were compared between the two groups.Binomial Logistic regression was used to analyze The relationship between objective sleep characteristics and suicidal ideation in elderly female patients with depression.Results Univariate analysis results showed that there was a statistically significant difference in occupational category,HAMD score,sleep efficiency,total sleep time,total awakening time,awakening frequency,N1 sleep time,N2 sleep time,N3 sleep time,and REML between the two groups of patients(P<0.05).Binomial Logistic regression analysis showed that after controlling for occupational categories and severity of depressive symptoms,sleep efficiency(OR=0.857,95%CI=0.748-0.983),total sleep time(OR=0.971,95%CI=0.947-0.996),awakening frequency(OR=1.092,95%CI=1.005-1.188),N1 sleep time(OR=1.059,95%CI=1.018-1.101),and N3 sleep time(OR=0.976,95%CI=0.956-0.996)are influencing factors for suicidal ideation in elderly female depression patients(P<0.05).Conclusions Some of the objective sleep characteristics of elderly female patients with depression,including decreased sleep efficiency,decreased sleep time,increased awakening frequency,prolonged sleep time in N1 phase,and decreased sleep time in N3 phase,make patients more prone to suicidal ideation.