抑郁症患者快动眼睡眠特征及其与抑郁水平的相关性

Objective To explore the characteristics of polysomnography (PSG) of depressed patients and the correlation between rapid eye movement (REM) and severity degree of depression. Methods Polysomnography was used to assess patients'sleep condition and Montgomery-Asberg depression scale (MADRS) was used to assess the severity degree of depression. 90 patients and 30 healthy controls were included. Results Compared to healthy controls,sleep progress of depressed patients changed as follow:prolonged sleep latency((25.2 ±15.25) minutes) ,lowered sleep efficiency(0.853 ±0.11) ;the architecture of sleep also changed:percentage of stage 1 increased( (27.7 ± 16.38) % ),percentage of REM sleep increased( (22. 8 ± 6. 1 ) % ) , percentage of stage 2 decreased ((40.2±11.3)%), percentage of slow wave sleep decreased ((11.8 ±9. 32)%); REM sleep significantly changed; decreased REM latency((79. 27 ±30. 44) minutes) , increased REM activity((129. 0 ±53. 12) u) .increased intensity of REM((36.7 ±14.0)u/min), increased REM density((159.2 ±57.2)u/min) were observed in depressed patients. There was no obvious correlation between the variance of REM and severity degree of depression. Conclusion There are a series of changes in sleep progress, architecture and REM sleep of depression and the change of REM sleep can be specified to diagnose depression. However,there is no causality between REM variance and severity of depression.     

晚发性抑郁患者睡眠障碍的多导睡眠图研究

目的 探讨晚发性抑郁患者睡眠障碍的多导睡眠图特点.方法 15例晚发性抑郁患者与10例健康老年人分别进行汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)的评分、多导睡眠记录仪的监测,次日行日间功能评定.结果 与对照组比较,晚发性抑郁患者睡眠进程明显紊乱,其中睡眠效率[(59.20±2.90)%,(77.09±1.55)%]、睡眠潜伏期[(54.00±4.97)min,(24.00±2.91)min]、异相睡眠(rapid eye movement,REM)次数[(4.50±0.40),(2.63±0.26)]和REM睡眠潜伏期(REM latency,REML)[(51.40±2.97)min,(79.00±3.56)min]差异有显著性(P＜0.01);与对照组比较,晚发性抑郁组的醒觉时间及百分比[(31.84±3.47)%,(18.17±1.95)%]增加,S2睡眠时相的时间[(116.40±11.16)min,(199.25±11.84)min]及百分比[(31.00±2.60)%,(48.67±1.46)%]明显增加,慢波睡眠时间减少,REM睡眠活动度、密度[(58.61±3.76),(40.64±1.88)]及强度增加(P＜0.05).结论 晚发性抑郁患者存在客观睡眠生理指标的紊乱;S2睡眠时间及百分比的增加、REM睡眠去抑制的表现有可能成为晚发性抑郁患者特异性的诊断指标.

Abstract：

Objective To explore ihe physiological changes of the late-onset depressive(LOD) persons during sleep.Methods 15 cases of LOD patients formed a group and 10 healthy aging persons formed a control group.Hamilton Depression Scale (HAMD) was used to score the severity of depression and polysomnographic recorders were used to monitor the whole night long.The subjective feelings of the sleep and the daytime mental status were assessed in the morning.Results Compared with the controlde group, the LOD patients obviously possessed a disordered sleeping process: sleep efficiency was lower( ( 59.20 ± 2.90 ) %, ( 77.09 ± 1.55 ) %, P ＜0.01 ); their sleep latency was longer( (54.00 ± 4.97 ), ( 24.00 ± 2.91 ), P ＜ 0.01 ); the numbers of rapid eye movement(REM) sleep phase and rapid eye movement latency(REML) were strikingly different(P＜0.01 ).Compad with the control group, the LOD patients' awakening time and percent were significantly increased.Not only were the time and percentage of S2 sleep phase much higher, but the time of slow wave sleep was shorter.Besides,REM sleep activity, its density, and its intensity were raised (P ＜ 0.05 ).Conclusion There is a disturbance of the objective physiological indexes happening among the LOD patients.The increase of S2 sleeping time and percentage and the disinhibition of REM sleep can be used as the diagnosis indexes of LOD patients' specificity.     

米氮平对早醒抑郁症患者睡眠脑电图及临床疗效的影响

目的 探讨米氮平对早醒抑郁症患者睡眠脑电图(PSG)及临床疗效的影响.方法 应用PSG对22例早醒病人、22例对照者进行检测.早醒病人米氮平治疗6周后复测PSG,在米氮平治疗前、治疗2周及6周后应用汉密尔顿抑郁量表(HAMD)评定患者的抑郁症状及早醒症状,比较治疗前后PSG指标与HAMD及早醒评分的变化.结果 与对照组比较,早醒组在PSG指标方面存在诸多异常.早醒组经过6周的米氮平治疗,PSG显示睡眠潜伏期缩短[(16.9±6.6) min],睡眠效率提高[(85.4±6.7)％],觉醒时间缩短[ (27.7±10.4)min],睡眠维持率提高[(87.9±5.3)％],慢性睡眠第一阶段(S1)百分比降低[(9.7±4.1)％],慢性睡眠第二阶段(S2)百分比提高[( 148.0±30.7)％],快动眼睡眠(REM)密度降低[(56.1±3.8)％];差异有显著性(P＜0.05).HAMD及早醒治疗后评分明显低于治疗前,差异具有显著性,(P＜0.001).相关分析显示HAMD及早醒的评分与PSG指标变化率无显著相关性(P＞0.05).结论 REM睡眠潜伏期缩短,REM睡眠时间延长,REM活动度和密度增加可能是抑郁症早醒的生物学标志之一,PSG变化与疗效无显著相关性.     

Sleep disorders and its related risk factors in patients undergoing chronic peritoneal dialysis

Background The prevalence of sleep disorders has been shown to be high in patients with chronic dialysis patients and may contribute to impaired quality of life and higher mortality in this population.However,there are few data on the relationship of sleep disorders and their risk factors in chronic dialysis patients.The aim of this study was to evaluate the relationship of sleep disorders and their risk factors in chronic dialysis patients.Methods A total of 42 continuous ambulatory peritoneal dialysis （CAPD） patients were involved in this cross-sectional study.Sleep quality was assessed by the Pittsburgh Sleep Quality Index （PSQI）.Restless legs syndrome （RLS） was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group.And depression was assessed by Hamilton depression scale.General information and laboratory data were collected.Results The prevalence of sleep disorders was 47.6％ in the CAPD patients.According to the PSQI,the 42 CAPD patients were divided into sleep disturbance group and non-sleep disorders group.There were no significant differences in age,gender,dialysis duration,hemoglobin,serum creatinine,urea nitrogen,β2-microglobulin,parathyroid hormone,calcium,and phosphorus between CAPD patients with sleep disorders and those without sleep disorders.But the level of serum albumin （AIb） in CAPD patients with sleep disorders was significantly lower than that in CAPD patients without sleep disorders （31.3±1.4 vs.34.3±3.7,t=3.603,P=0.001）.And the prevalence of RLS and depression was significantly higher than that in CAPD patients without sleep disorders （RLS：11/22 vs.1/20,x2=10.395,P=0.001; depression：7/22 vs.1/20,x2=4.886,P=0.027）.In CAPD patients with RLS,the prevalence of sleep disorders was significantly higher than that in CAPD patients without RLS （11/22 vs.11/30,x2=10.395,P=0.001）.And in CAPD patients with depression,the prevalence of sleep disorders was significantly higher than that in CAPD patients without depression （7/8 vs.15/34,x2=4.886,P=0.027）.In CAPD patients,bivariate correlation analysis showed that sleep disorders was negatively correlated with serum AIb （r=-0.606,P=0.000） and positively correlated with RLS （r=0.497,P=0.001） and depression （r=0.341,P=0.029）.Multivariate regression analysis revealed that the odds ratio of RLS,depression,and low serum AIb was 22.900,42.209,and 0.597,respectively.Conclusions The prevalence of sleep disorders was relatively high in CAPD patients.RLS,depression,and low serum AIb were the risk factors for CAPD patients with sleep disorders.     

Subjective sleepiness in heart failure patients with sleep-related breathing disorder

Background Previous studies show that sleep-related breathing disorder （SRBD） is common in patients with heart failure （HF） and is associated with increased mortality. This study aimed to determine whether there was significant difference of subjective daytime sleepiness between HF patients with and without SRBD. Methods We enrolled, prospectively, 195 consecutive HF patients with left ventricular ejection fractions （LVEF） ≤45% and all subjects underwent polysomnography to measure the sleep structure between 2005 and 2008. Patients were then assigned to those with SRBD including obstructive and central sleep apnea （apnea-hypopnea index （AHI） ≥5/hour of sleep） and those without SRBD （AHI 〈5/hour） according to the sleep study. The subjective sleepiness was assessed with Epworth sleepiness scale （ESS）. Results Among 195 HF patients, the prevalence of obstructive sleep apnea （OSA） was 53% and of central sleep apnea （CSA） was 27%. There was no significant difference of ESS scores between patients without SRBD （NSA） and with SRBD （NSA vs OSA： 6.7±0.6 vs 7.6±0.4, P=0.105 and NSA vs CSA： 6.7±0.6 vs 7.4±K）.5, P=0.235, respectively）, indicating that SRBD patients had no more subjective daytime sleepiness. Compared with NSA, patients with SRBD had increased arousal index （Arl） （NSA vs OSA： 14.1±1.4 vs 26.3 ±1.5, P〈0.001 and NSAvs CSA： 14.1±1.4 vs 31.3±3.5, P 〈0.001, respectively）, more awake number after sleep onset （NSA vs OSA： 19.2±1.5 vs 26.2±1.4, P=0.01 and NSA vs CSA： 19.2±1.5 vs 36.9±4.4, P 〈0.001, respectively）, and reduced proportion of slow-wave sleep （SWS） （NSA vs OSA： 13.8±1.7 vs 9.3±0.7, P=0.024 and NSA vs CSA： 13.8±1.7 vs 8.9±0.9, P=0.024, respectively）. Conclusions OSA and CSA remain common in patients with HF on optimal contemporary therapy. Patients with both HF and SRBD have no significant subjective daytime sleepiness compared with patients without SRBD, despite of significantly increased awake number, arousal and decreased proportion of deep sleep stages. It is not a credible way and means to exclude SRBD in patients with HF according to the absence of subjective daytime sleepiness.     

Serum Level of Vascular Endothelial Growth Factor in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

To explore the relationship between the serum vascular endothelial growth factor (VEGF) level and the severity of obstructive sleep apnea hypopnea syndrome (OSAHS), the concentrations of serum VEGF in 40 OSAHS patients and 9 healthy controls were measured by using ELISA method. Meanwhile the correlation between the concentration of VEGF and parameters of polysomnography (PSG) was examined. Our results showed that the concentrations of VEGF were significantly higher in OSAHS patients with severe hypoxia (536.8±334.7 pg/mL) than in those with mild hypoxia (329.2±174.7 pg/mL) and healthy controls (272. 8±211.0 pg/mL) (P<0.05 for both). The concentra- tions of VEGF were also significantly higher in OSAHS patients with hypertension (484.5±261.4 pg/mL) than in those without hypertension (311.0±158.4 pg/mL) and healthy controls (272. 8± 211.0 pg/mL) (P<0.05 for both). There was a positive correlation between the concentration of VEGF and the apnea hypopnea index (AHI) (r=0.34, P<0.05). It is concluded that the concentration of the serum VEGF is positively related to the severity of OSAHS. The elevated serum VEGF level may be involved in the pathogenesis of the complications of obstructive sleep apnea hypopnea syndrome.     

Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese: a multi-center investigation in China

Background Epidemiologic studies have shown an independent and definite association between obstructive sleep apnea （OSA） and hypertension. This study aimed to define the association between daytime blood pressure and severity of OSA in Chinese population in mainland of China. Methods Twenty university hospital sleep centers in mainland of China were invited by the Chinese Medical Association （CMA） to participate in this epidemiologic study and 2297 consecutive patients （aged 18-85 years; 1981 males and 316 females） referred to these twenty sleep centers for evaluation of OSA between January 2004 and April 2006 were prospectively enrolled. Nocturnal polysomnography was performed in each patient, and disease severity was assessed based on the apnea-hypopnea index （AHI）. These patients were classfied into four groups： non-apneic control （control, n=257） with AHI 〈5 episodes/hour; mild sleep apnea （mild, n=402） with AHI 〉5 and 〈15 episodes/hour; moderate sleep apnea （moderate, n=460） with AHI 〉15 and 〈30 episodes/hour and severe sleep apnea （severe, n=1178） with AHI 〉30 episodes/hour. Daytime blood pressure measurements were performed under standardized conditions in each patient at 10 a.m. in office on the day of referring to sleep centers for getting average value. All the patients were requested to quit medications related to blood pressure for three days before the day of assessing. Results Both daytime systolic blood pressure and diastolic blood pressure values were significantly related to AHI positively （r = 0.201 and 0.276, respectively; both P values 〈0.001） and to nadir nocturnal oxygen saturation negatively （r = -0.215 and -0.277, respectively; both P values 〈0.001）, which were the parameters of OSA severity. In two special designed mean plots, means of daytime systolic and diastolic blood pressure increased gradually with increasing AHI. Beyond AHI of 61-65, this increasing trend reached a plateau. Conclusions The results showed that OSA severity was associated with daytime blood pressure until AHI of 61-65, providing evidence for early OSA management, especially in OSA patients with concomitant hypertension.     

黛力新与多塞平联合治疗原发性失眠

目的:观察黛力新和多塞平联合应用治疗原发性失眠的疗效. 方法: 采用随机、单盲、安慰剂、对照方法,将180例原发性失眠患者随机分为治疗组、阿普唑仑组和安慰剂组各60例,治疗12 wk. 采用多导睡眠图描记技术评价疗效. 结果: ①治疗组:治疗后较治疗前睡眠潜伏期明显缩短[(28.33±3.48)和(14.84±5.31) min,P<0.01],觉醒次数和时间明显减少[分别为(8.89±1.46)和(4.25±2.25)次;(56.33±6.92)和(22.45±8.15) min,P<0.01],总睡眠时间及睡眠效率明显提高(分别为340.44±20.58和412.02±28.42;70.22±10.47和91.49±12.47,P<0.01);睡眠结构分析,浅睡较前减少,尤其Ⅰ期睡眠明显[(19.38±2.34)和(10.37±3.92)%,P<0.01],而深睡(Ⅲ,Ⅳ期)明显增加[(10.33±1.26)和(18.96±2.88)%,P<0.01],快速眼动睡眼相(REM)睡眠比例有所增加[(14.67±2.14)和(20.96±3.28)%,P<0.01]. ②阿普唑仑组:治疗后较治疗前睡眠潜伏期缩短[(29.13±4.36)和(12.45±3.17) min,P<0.05],总睡眠时间延长[(356.90±22.09)和(425.86±26.57) min,P<0.01],觉醒时间减少[(54.39±5.17)和(38.79±9.45) min,P<0.01],而睡眠效率没有明显变化;睡眠结构分析,浅睡(Ⅱ期睡眠)增加[(58.29±9.67)和(71.18±6.58)%,P<0.01],而深睡减少[(12.04±1.22)和(6.72±2.32)%,P<0.01],REM参数无变化;安慰剂组除睡眠潜伏期减少外,其余参数均无变化. 结论: 黛力新和多塞平联合应用治疗原发性失眠的疗效确切.     

Clinical Research of Acupuncture on Malignant Tumor Patients for Improving Depression and Sleep Quality

Objective:To study the effect of acupuncture on depression and insomnia of malignant tumor patients.Methods:Eighty cases of cancer related depression and sleep disorders were randomly divided into 2 groups:treatmentl group(acupuncture n=40) and control group(Fluoxetione n=40).All patients were assessed by Self-rating Depression Scale(SDS),Hemilton Depression Rating Scale(HAMD) and Pittsburgh Sleep Quality Index(PSQI) after treatment for 30 days.Results:Before treatment the SDS and HAMD scores of the trial group were 64.12±5.34 and 20.92±2.38,those of the control group were 64.24±4.98 and 20.72±2.74,after treatment the SDS and HAMD scores of the trial group were 43.64±5.28 and 9.88±1.27 respectively,significantly lower than those of the control group(50.76±5.42 and 13.72±2.05 respectively,both P<0.05).Before treatment the PSQI score of the trial group and the control group were 14.48±1.71 and13.92±2.59,after treatment the PSQI score of the trial group was 7.92±1.22 after treatment,significantly lower than those of the control group(11.44±1.89,P<0.01).Conclusion:Acupuncture can effectively reduce malignant-related depression,improve sleep quality,and help to improve the quality of life of cancer patients.     

阻滞性与非阻滞性抑郁症患者睡眠脑电图研究

目的 探讨阻滞性和非阻滞性抑郁症患者多导睡眠图(polysomnography,PSG)的特点.方法 将符合中国精神障碍分类与诊断标准第3版(CCMD-3)中单相抑郁症的诊断标准,且1月内未服用药物的28名抑郁症患者按汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)阻滞因子得分,分为阻滞组(n=14)和非阻滞组(n=14),并与15名正常对照组进行对照.3组均进行PSG测定.结果 与对照组相比,阻滞组和非阻滞组睡眠总时间、睡眠效率下降(t=-2.32,-2.17;t=-2.34,-2.16),睡眠潜伏期延长(t=2.87,2.93),觉醒时间、觉醒次数、觉睡比增加(t=2.97,2.84,3.02;t=2.85,2.80,2.98),S1百分比、快眼动睡眠(REM)百分比均增加(t=2.23,2.16;t=2.19,2.08),慢波睡眠比例降低(t=-2.44,-2.36),REM睡眠时间、睡眠潜伏期缩短(t=-2.21,-2.56;t=-2.52,-2.48),REM活动度、强度增加(t=2.73,2.76;t=2.28,2.55),均差异有统计学意义(均P＜0.05或0.01).阻滞组REM密度[(170±24.8)μ/min]高于非阻滞组[(145±21.8)μ/min]和对照组[(122±19.4)μ/min,t=2.36,2.75,P＜0.05).结论 阻滞性和非阻滞性抑郁症PSG都呈现出异常表现,阻滞症状越突出,REM密度可能越高.阻滞性与非阻滞性抑郁症之间PSG并未表现出显著差异.     

老年期与非老年期抑郁症患者客观睡眠状况研究

目的 比较老年期与非老年期抑郁症患者客观睡眠情况的差别. 方法 对老年组(n=43)、非老年组(n=28)以及对照组(n=20)抑郁症患者进行多导睡眠监测(PSG)检查,获得客观睡眠数据. 将数据进行组间对比分析. 结果与对照组比较,老年组与非老年组实际睡眠时间( AST)、快眼动睡眠潜伏期( REML)、快眼动睡眠期( REM)、快眼动睡眠期比例( REM%)均出现降低;在非快眼动睡眠期( NREM)中,老年组与非老年组在非快眼动睡眠1期( N1 )时间及其所占比例( N1%)、非快眼动睡眠2 期( N2 )时间及其比例( N2%)、非快眼动期睡眠时间比例( NREM%)较对照组均有显著差异(P<0. 05). 老年组较对照组睡眠潜伏期(SL)延长,睡眠效率( SE)降低,N3、N3%、NREM降低,睡眠呼吸暂停与低通气指数( AHI )升高,睡眠平均和最小血氧饱和度、REM及NREM期血氧饱和度降低. 与非老年组比较,老年组AST缩短, SL延长, REML缩短, NREM与N3 期下降,而NREM%升高;AHI偏高、睡眠平均和最小血氧饱和度、REM及NREM期血氧饱和度偏低,组间差异有统计学意义(P<0. 05). 结论 老年期与非老年期抑郁症患者较健康对照均存在睡眠结构及睡眠呼吸的异常,而老年期抑郁症患者睡眠结构及睡眠呼吸异常情况更为严重.     

针刺结合生物反馈疗法治疗老年慢性失眠的临床研究

目的 探讨针刺疗法结合生物反馈疗法治疗老年慢性失眠的临床效果.方法 150名老年慢性失眠症自愿受试患者,按就诊顺序分成3组,A组单纯接受针刺加耳穴贴磁珠治疗,B组单纯接受生物反馈放松疗法,C组接受上述两种疗法联合治疗.单盲法评估、记录3组患者在治疗前、治疗后4周末、8周末的匹兹堡睡眠质量指数(PSQI)、睡眠效率、入睡时间、总睡眠时间及汉密顿焦虑量表(HAMA)总分、汉密顿抑郁量表(HAMD-17)总分及副反应观察.结果 治疗8周末时,联合治疗组的PSQI总分、睡眠效率、入睡时间、总睡眠时间以及HAMA总分、HAMD总分等指标[分别为(7.92±2.59)分,(82.52±8.93)%,(24.06±8.23)min,(413.75±42.41)min,(9.63±3.75)分,(10.10±3.27)分]均好于其他两组[分别为针刺组(9.51±2.92)分,(79.06±10.70)%,(33.16±11.31)min,(373.47±40.65)min,(15.08±4.20)分,(14.33±3.56)分;生物反馈组(11.46±3.75)分,(68.85±12.34)%,(33.65±11.38)min,(281.88±38.02)min,(11.63±4.15)分,(12.08±4.08)分],差异有显著性(P＜0.01).结论 针刺结合生物反馈疗法能显著改善老年人慢性失眠的睡眠质量,并且能改善与失眠相关的焦虑和抑郁不良心理状态.     

整夜多导睡眠图记录在抑郁症患者诊断中应用

目的：观察自然夜间多导睡眠图（PSG）对抑郁症的诊断价值。方法：应用日本光电1500型多导生理记录仪，对19例抑郁症患者和21名正常人进行多导睡眠图检查，结果：1．抑郁症组表现为醒觉时间增加、睡眠效率和睡眠维持均下降，第三、四阶段睡眠百分比改变和快速眼球运动潜伏缩短，与健康对照组相比有显著性差异（P＜0．05－0．01）。2、抑郁症组的入睡困难，早醒及睡眠维持率障碍的发生率均显著高于对照组（P＜0．05－0．01），结论：多导睡眠图中的REM指标改变是抑郁症患者所具有的特定脑电生物学指标，应与神经内分泌和神经递质结合起来进一步追踪研究。     

短睡眠者和长睡眠者睡眠结构、个性特征及情绪状况的比较

目的 了解和比较短睡眠者和长睡眠者的睡眠结构和心理特征.方法 在600名大学生中,选择睡眠最短和最长的各30名学生将作为短睡眠者、长睡眠者参加睡眠和心理测评.睡眠检查包括夜晚多导睡眠检查和次日多次睡眠潜伏期测验,心理测评包括艾森克人格量表、状态/特质焦虑量表、贝克抑郁量表和Epworth困倦量表.结果 短睡眠者、长睡眠者的慢波睡眠绝对长度相似[(79.1±17.7)min,(82.2±15.9)min,t=0.277,P=0.191];长睡眠者的Ⅱ期睡眠[(191.6±43.0)min,(240.6±74.9)min,t=23.587,P=0.000)和快动眼睡眠[(90.8±27.5)min,(129.8±47.0)min,t=9.540,P=0.000]的绝对长度、以及快动眼密度都高于短睡眠者;长睡眠者的神经质水平和焦虑抑郁水平高于短睡眠者,而内外向人格差异未达到统计学差异.结论 慢波睡眠可能是睡眠的核心成分,Ⅱ期睡眠可能是可选择成分;长睡眠者对快动眼睡眠和快动眼密度需求较高,长睡眠者的高神经质水平和焦虑抑郁水平在睡眠特征中也有所反映.     

帕罗西汀对Sprague—Dawley大鼠睡眠呼吸暂停的影响

目的 研究选择性5-羟色胺再摄取抑制剂(SSRIs)帕罗西汀对SD大鼠睡眠呼吸暂停的影响.方法 30只成年雄性SD大鼠随机分为帕罗西汀治疗组及对照组,每组15只,分别给予腹腔注射帕罗西汀(10 mg·kg-1·d-1)及灭菌蒸馏水(2 mL·kg-1·d-1)共7 d.给药前后分别进行睡眠监测,观察睡眠呼吸暂停指数(AI)及睡眠结构的变化.结果 帕罗西汀治疗组AI由(12.4±3.7)次/h降至(7.4±2.2)次/h(P=0.000),非快动眼睡眠(NREM)期叹息后呼吸暂停指数(PSAI)及自发呼吸暂停指数(SPAI)均有显著性下降(P=0.000,0.021),快动眼睡眠(REM)期呼吸暂停指数的下降无统计学意义.给予帕罗西汀后REM睡眠由8.6%降至8.0%(P=0.013),入睡潜伏时间由(20.7±9.1)min增至(30.0±15.7)min(P=0.038),REM潜伏期时间由(54.1±48.4)min增至(110.9±43.4)min(P=0.001).对照组上述指标的变化均无统计学意义(P均>0.05).结论 帕罗西汀可改善SD大鼠的睡眠呼吸暂停指数(AI)及NREM期PSAI和SPAI,对睡眠结构的影响表现为抑制REM睡眠并延长人睡潜伏期.     

失眠症患者睡眠质量、心理健康状况及其多导睡眠图的研究

目的探讨失眠症患者的睡眠质量、心理健康状况及其相互关系,并通过对多导睡眠图(PSG)睡眠参数的定量分析,对失眠症患者的主客观睡眠状况进行评估。方法对失眠症患者和正常人各98例分别运用匹兹堡睡眠质量指数问卷(PSQI)、症状自评量表问卷(SCL-90)进行评定,并分别进行多导睡眠图的整夜睡眠描记,次日晨起后询问夜间睡眠情况。结果失眠症组PSQI各成分得分及总分均高于对照组,差异有显著性(P<0.01);失眠症组SCL-90评定总分及躯体化、抑郁、焦虑各因子分[分别为(72.89±25.67)分,(2.13±0.49)分,(2.25±0.69)分]与对照组[分别为(31.28±12.73)分,(1.81±0.58)分,(0.73±0.57)分]比较,差异有显著性(P<0.05)。失眠症组的睡眠潜伏期延长、总睡眠时间减少、觉醒次数增多、睡眠效率降低、快眼动睡眠时间减少[分别为(43.69±11.54)分,(314.65±91.89)分,(9.89±9.07)分,(64.51±18.59)分,(33.26±15.61)分],与对照组[分别为(16.01±10.44)分,(446.41±77.81)分,(3.54±2.89)分,(91.32±3.58)分,(93.21±21.63)分]相比,差异有显著性(P<0.01)。失眠症组自我对总睡眠时间的评估较PSG检测值显著减低、对睡眠潜伏期的评估较PSG检测值显著增高,自我评估与实际睡眠时间不一致。结论失眠症患者不仅睡眠质量差,且伴有较多的心身症状。失眠越严重,心身症状就越明显。失眠症患者的PSG各睡眠参数有特征性的改变,利用PSG定量分析可区分出主观性失眠和客观性失眠。失眠症患者对失眠情况的主观评估与客观检测结果不一致,存在过高估价睡眠潜伏期和过低估价睡眠时间的倾向。     

阻塞性睡眠呼吸暂停低通气综合征患儿睡眠结构的分析

目的：研究阻塞性睡眠呼吸暂停低通气综合征患儿的睡眠结构的特点。方法：通过分析51例OSAHS患儿多导睡眠图,与同年龄组儿童睡眠结构正常值进行比较。 结果:OSAHS患儿的睡眠结构有如下特点：睡眠Ⅰ期（S1期）所占比例增加(9.37±6.78)%,与同年龄组儿童睡眠结构(2.30±1.10)%相比差异有显著性（P＜0.01）;睡眠Ⅱ期（S2期）（49.65±7.02）%,与同年龄组儿童睡眠结构(47.92±4.37)%相比差异无显著性（P﹥0.05）;慢波睡眠期（SWS期,Ⅲ期+Ⅳ期）所占比例增加（37.29±9.57）%,与同年龄组儿童睡眠结构(21.10±5.00)%相比差异有显著性（P＜0.01）;快动眼睡眠（REM期）所占比例减少（3.69±3.44）%,与同年龄组儿童睡眠结构(28.23±4.14) %相比差异有显著性（P＜0.01）。睡眠Ⅰ、Ⅱ期的AHI（11.19±7.65）与慢波睡眠期的AHI（3.55±2.34）相比,差异有显著性（P＜0.05﹚,与REM期的AHI（12.3±13.42）相比,差异无显著性（P＞0.05﹚,慢波睡眠期的AHI与REM期的AHI相比,差异有显著性（P＜0.05﹚。 结论：阻塞性睡眠呼吸暂停低通气综合征可引起患儿睡眠结构的改变,表现为S1期和SWS 的增加,快动眼睡眠的减少,呼吸事件多发生在睡眠Ⅰ、Ⅱ期和快动眼睡眠期。