老年人群抑郁症状与睡眠障碍的相关性研究

Association study of sleep disorders and depression in the elderly

目的基于客观和主观方法监测老年人睡眠障碍情况,研究睡眠障碍与抑郁症之间的相关性。方法选取2016年9月至2018年2月入住我院有睡眠障碍症状的老年病人594例。采用腕式睡眠监测仪和多导睡眠仪记录老年病人平均睡眠时间、睡眠连续性等情况;采用WHIIRS(Women's Health Initiative Insomnia RatingScale)量表、ESS(the Epworth Sleepiness Scale)量表和CES-D量表分别调查老年病人失眠症状、嗜睡情况和抑郁情况,并且按CES-D<16分和CES-D≥16分分为正常组与抑郁症状组。通过广义线性模型分析睡眠障碍与抑郁症状的相关性。结果 594例老年病人中14. 5%患有抑郁症状,30. 4%的睡眠时间较短(<6 h),27. 9%具有失眠症状,12. 6%患有日间过度嗜睡,14. 6%患有阻塞性睡眠呼吸暂停低通气综合征。回归分析结果显示,睡眠时间短(PR=1. 47,95%CI:1. 11～1. 94)、失眠(PR=1. 78,95%CI:1. 36～2. 40)和日间过度嗜睡(PR=1. 61,95%CI:1. 19～2. 18)均与抑郁症状具有显著的统计学关联。结论老年人睡眠时间短、失眠等睡眠障碍与抑郁的患病风险存在显著的相关性。

Objective To investigate the prevalence of sleep disorders,and to study the association between sleep disorders and depression. Methods A total of 594 elderly patients from Gerontology Department of our hospital during September 2016 to February 2018 were enroll in the study.Sleep duration and continuity were assessed with actigraphy and polysomnography. Sleep quality was assessed by using the Women’s Health Initiative Insomnia Rating Scale( WHIIRS) and the Epworth Sleepiness Scale( ESS),and depressive symptoms were assessed by using the Center for Epidemiologic Studies Depression( CES-D) scale. General linear model was used to evaluate the association of sleep quality with depression( CES-D score ≥ 16). Results In 594 cases,14. 5% presented with depression,30. 4% patients presented with short sleep duration( < 6 hours),27. 9% presented with insomnia symptoms,12. 6% patients presented with excessive daytime sleepiness( EDS),and 14. 6%patients presented with obstructive sleep apneahypopnea syndrome. The general linear model showed that short sleep duration [adjusted prevalence ratio( PR) = 1. 47,95% CI: 1. 11-1. 94],insomnia( PR =1. 78,95%CI: 1. 36-2. 40) and EDS( PR = 1. 61,95%CI: 1. 19-2. 18) were associated with depression.Conclusions Sleep disorders such as short sleep duration and insomnia are associated with depression in the elderly people.