Contribution of attachment insecurity to health-related quality of life in depressed patients

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life (HRQoL) in patients diagnosed with adjustment disorder (AJD) with depressed mood.METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance (ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package (SPSS Inc., Chicago, IL, United States).RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggest that depressive symptoms were more severe (F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer (F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQoL, accounting for 21.4% and 29.7% of the total variance, respectively [R² = 0.79; Adjusted R² = 0.77; F (5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in AJD with depressed mood.     

The importance of sleep and physical activity on well-being during COVID-19 lockdown: reunion island as a case study

BackgroundLockdown has been one of the major worldwide strategies to control the spread of coronavirus disease 2019 (COVID-19). Its consequences on the well-being of individuals needs to be better understood. The objective of this work was to evaluate the impact of lockdown on the well-being of a general population and the factors associated with this potential impairment of well-being in a population that has been only lightly affected by COVID-19 such as in Reunion island, an overseas French department.MethodsAn online survey was proposed to the population of Reunion Island between the 35th and 54th days of lockdown relative to pre- and per-lockdown periods. Well-being was measured by the 5-item World Health Organization Well-Being Index, with some questions about sleep habits (Pittsburgh questionnaire), weekly physical activity (IPAQ), health, and lifestyle.ResultsFour hundred volunteers answered the survey. They reported a 15.7% decrease in well-being (p < 0.001), accompanied by increased anxiety (p < 0.001), decreased weekly physical activity (p < 0.001), delayed and poorer quality sleep (p < 0.001). Multivariate logistical analysis showed that impairment in well-being during lockdown was independently associated with an increase in anxiety (odds ratio (OR): 4.77 (3.26–6.98), p < 0.001), decrease in weekly physical activity (OR: 0.58 (0.43–0.79), p < 0.001), and poor-quality sleep (OR: 0.29 (0.19–0.43), p < 0.001).ConclusionsThis study suggested an impairment in well-being during lockdown, associated with anxiety, lack of physical activity and sleep disruptions. Public policies must consider these factors as levers for improving the well-being of the population in order to effectively combat the spread of COVID-19.     

Abnormal night sleep duration and poor sleep quality are independently and combinedly associated with elevated depressive symptoms in Chinese rural adults: Henan Rural Cohort

ObjectiveTo assess the independent and combined effects of night sleep duration and sleep quality on depressive symptoms.MethodsA total of 28,202 participants (11,236 males and 16,966 females) aged 18–79 years from the Henan Rural Cohort were included in this study. Night sleep duration and sleep quality were defined by the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and restricted cubic splines were applied to evaluate the association of night sleep duration and sleep quality with depressive symptoms.ResultsA U-shaped dose-response relationship between night sleep duration and depressive symptoms along with a J-shaped relationship between sleep quality and depressive symptoms were observed. Compared with reference group (7-<8 h), shorter sleep duration (<6 h) and longer sleep duration (≥10 h) were associated with increased risk of depressive symptoms in males (short sleep: Odds Ratio (OR) = 1.84, 95% confidence interval (CI), 1.34–2.52; long sleep: OR = 1.56, 95% CI, 1.01–2.42) and females (short sleep: OR = 2.19, 95% CI, 1.77–2.70; long sleep: OR = 1.51, 95% CI, 1.10–2.10). Compared with good sleepers, poor sleepers had 4.23-fold (95% CI:3.54–5.06) and 3.87-fold (95% CI: 3.41–4.40) increased odds of depressive symptoms in males and females. Furthermore, participants with longer night sleep duration (≥10 h) and poorer sleep quality had the strongest effect on depressive symptoms (males: OR = 6.64, 95% CI, 3.21–13.74; females: OR = 7.76, 95% CI, 5.00–12.02).ConclusionsExtreme night sleep duration and poor sleep quality were independently and combinedly related to elevated depressive symptoms, suggesting that keeping optimal night sleep duration and good sleep quality maybe benefit for maintaining mental health.Trial registrationChinese Clinical Trial Register. Registration number: ChiCTR-OOC-15006699.     

Partial sleep deprivation: impact on the architecture and quality of sleep

Objective: The study was aimed at the examination of the acute and cumulative impact of partial sleep deprivation (PSD) on architecture and quality of sleep, on circadian rhythm and on daytime fatigue.Methods: Time in bed for 16 healthy male volunteers was reduced from 8 to 5 h during four consecutive nights, followed by two recovery nights. This scheme matches the terms of service and sleep rhythms of rescue helicopter pilots in Germany. Polysomnography was recorded during each night, and motor activity and body core temperature were recorded continuously. Subjective sleep quality and alertness were acquired by questionnaires.Results: In the course of PSD, electroencephalography (EEG) showed a reduction of S1 and S2 (p = 0.039), whereas S3, S4 (0.024) and rapid eye movement (REM; p = 0.030) sleep increased. Subjective sleep quality improved, while sleep need (p < 0.001) and fatigue (p < 0.001) deepened. These effects declined rapidly after one recovery night.Conclusions: PSD alters sleep and daytime alertness. The results indicate that not only slow wave sleep (SWS) but also REM is important for sleep. Sleep became more effective when wake periods and sleep latencies decreased, thereby improving subjective sleep quality. Sleepiness, sleep need and fatigue increased immediately and accumulated throughout the restricting procedure.     

奎硫平对酒依赖患者稽延性戒断症状及睡眠的影响

目的:评估奎硫平对酒依赖患者稽延性戒断症状的治疗效果及睡眠质量和睡眠结构的影响。方法:选取80例酒依赖患者急性期戒酒治疗后随机分为奎硫平治疗组(研究组)和维生素治疗组(对照组),研究组给予200~400 mg/d奎硫平治疗,对照组给予维生素治疗。采用宾西法尼亚酒精渴求量表(PACS)、视觉模拟渴求量表(VAS)及汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)分别于入组时和治疗4周对两组患者进行评定,同时接受多导睡眠图(PSG)检测。结果:治疗前两组PACS、VAS和HAMD、HAMA评分差异无统计学意义(P0.05),治疗后研究组PACS、VAS和HAMD、HAMA总分较治疗前均显著降低,差异有统计学意义(P0.05)。治疗前两组PSG各指标差异无统计学意义(P0.05),治疗后研究组觉醒次数(AN)减少[(5.93±1.53)vs(6.91±1.60),t=2.559,P=0.000],睡眠效率(SE)升高[(68.3±4.17)vs(60.8±4.20),t=7.316,P=0.000],总睡眠时间(TST)增加[(292.5±25.9)vs(271.7±23.3),t=3.451,P=0.018],差异有统计学意义。睡眠潜伏期(SL)、快眼动睡眠(REM)百分比及REM睡眠潜伏期(RL)等指标两组间差异无统计学意义(P0.05)。对照组治疗前后各指标差异无统计学意义(P0.05)。结论:奎硫平可改善酒依赖患者急性戒断后的心理渴求、焦虑、抑郁等稽延性戒断症状,提高部分睡眠质量。     

The impact of sleep quality on the mental health of a non-clinical population

IntroductionSleep quality relates to mental health in clinical and non-clinical populations. However, there is more evidence of this relationship in clinical populations. Therefore, there is lack of evidence on how these variables relate and on which sociodemographic factors influence this relationship in non-clinical populations. In this study we hypothesize that in a non-clinical population sleep quality predicts mental health indicators and that age, country and gender moderate this relationship.MethodsIn a sample of 1552 subjects from Portugal, Spain and Brazil, self-reported sleep quality and mental health indicators were assessed through the Pittsburgh Sleep Quality Index and the Depression, Anxiety and Stress Scale-21, respectively. A multivariate linear regression model was used to test the research hypotheses.ResultsThis adjusted model explained 10.1%, 12.3% and 13.1% of the variability of Depression, Anxiety and Stress, respectively, suggesting multiple sources of variance.ConclusionsOur results confirmed that sleep quality predicts mental health in non-clinical populations, and that the variable country is a significant moderator of this relationship.     

The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report

BackgroundPrevious studies have suggested a bidirectional association between sleep problems and anxiety symptoms in adolescents. These studies used methods that do not separate between-person effects from within-person effects, and therefore their conclusions may not pertain to within-person mutual influences of sleep and anxiety. We examined bidirectional associations between sleep problems and anxiety during adolescence and young adulthood while differentiating between person effects from within-person effects.MethodsData came from the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study including six waves of data spanning 15 years. Young adolescents (N = 2230, mean age at baseline 11.1 years) were followed every 2–3 years until young adulthood (mean age 25.6 years). Sleep problems and anxiety symptoms were measured by the Youth Self-Report, Adult Self-Report and Nottingham Health Profile. Temporal associations between sleep and anxiety were investigated using the random intercept cross-lagged panel model.ResultsAcross individuals, sleep problems were significantly associated with (β = 0.60, p < 0.001). At the within-person level, there were significant cross–sectional associations between sleep problems and anxiety symptoms at all waves (β = 0.12–0.34, p < 0.001). In addition, poor sleep predicted greater anxiety symptoms between the first and second, and between the third and fourth assessment wave. The reverse association was not statistically significant.ConclusionsWithin-person associations between sleep problems and anxiety are considerably weaker than between-person associations. Yet, our findings tentatively suggest that poor sleep, especially during early and mid-adolescence, may precede anxiety symptoms, and that anxiety might be prevented by alleviating sleep problems in young adolescents.     

The effect of caffeine reduction on sleep quality and well-being in persons with HIV

OBJECTIVES: With reports of high rates of sleep disruption in Human Immunodeficiency Virus (HIV) + persons, this study tested whether there were differences in sleep quality and well-being between a group of HIV+ persons who reduced their caffeine intake from baseline by 90% or greater for 30 days (n=44) versus a group of HIV+ persons who continued their usual caffeine consumption (n=44). METHODS: Subjects were administered pre- and post-Pittsburgh Sleep Quality Index (PSQI), Perceived Well-being Scale-Revised (PWB-R) and MOS-HIV Health Survey instruments, with MOS-HIV summary scores used as a covariate. RESULTS: On ANCOVA analysis for sleep quality (F=14.032, P<.001), a 35% improvement in sleep among experimental subjects was identified. There was no significant difference between the two groups on ANCOVA analysis for well-being (F=0.111. P=.739). CONCLUSIONS: High levels of caffeine consumption may have an exacerbating effect on already prevalent HIV-related sleep pattern disturbances, and significant reductions of caffeine may improve sleep quality.     

The relationship of attachment insecurity to subjective stress and autonomic function during standardized acute stress in healthy adults

OBJECTIVE: The purpose of this study was to test predicted relationships between adult attachment and stress using subjective and physiological measures. METHODS: Sixty-seven healthy adults completed measures of adult attachment and perceived chronic stress. Subjective stress and the high-frequency (HF) and low-frequency (LF) spectral bandwidths of heart rate variability (HRV) were measured during a standardized stress protocol. RESULTS: Attachment anxiety is associated with between-subject differences in chronic perceived stress (P=.001) and subjective acute stress (P=.01). There is a main effect of attachment avoidance on between-subject differences in HF HRV (P=.004). Attachment avoidance is inversely associated with HF HRV, independent of age and variability in respiration. CONCLUSION: Attachment anxiety is associated with self-reported distress. Attachment avoidance is inversely associated with HF HRV, a marker of vagal influence on cardiac activity, but is not associated with subjective stress.     

The association between physical activity and sleep quality in stroke-free adults living in rural settings. The Three Villages Study

Background/objectivesThe relationship between physical activity and sleep quality has been reported in specific conditions or in selected individuals. To better understand this association at the population level, we aimed to assess the association between physical activity and sleep quality in community-dwellers residing in three neighboring rural villages of Coastal Ecuador.MethodsA total of 1438 individuals aged ≥40 years were included. Data collection focused on the levels of physical activity and sleep quality. Multivariate models were fitted to assess independent associations between adequate physical activity and good sleep quality, after adjusting for relevant covariates.ResultsPhysical activity was categorized as ideal in 676 (47%) individuals, intermediate in 644 (45%), and poor in 118 (8%). According to the Pittsburgh Sleep Quality Index (PSQI), 880 (61%) individuals had a good sleep quality. In univariate analysis, the percentage of individuals with a good sleep quality was lower among individuals with poor and intermediate physical activity when compared to those with ideal physical activity. Using individuals with poor physical activity as the referent category, a logistic regression model showed that a good sleep quality was significantly associated with intermediate (odds ratio, OR: 1.54; 95% confidence interval, CI: 1.03–2.30; p = 0.036) and ideal (OR: 1.78; 95% C.I.: 1.18–2.69; p = 0.006) physical activity, after adjusting for relevant covariates.ConclusionsThis population-based study provides robust epidemiological evidence favoring an association between adequate levels of physical activity and good sleep quality in middle-aged and older adults living in rural settings.     

月经性偏头痛患者焦虑抑郁症状及睡眠质量

目的 探讨月经性偏头痛患者的焦虑抑郁症状及睡眠质量,为防治月经性偏头痛及其共病提供参考。方法根据国际头痛疾病分类第3版(ICHD-3)诊断标准,选择2019年2月-2020年2月在川北医学院附属医院门诊就诊的501例女性偏头痛患者为研究对象,包括112例月经性偏头痛患者和389例非月经性偏头痛患者。收集患者的一般资料及临床资料,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表24项版(HAMD-24)、头痛影响测评量表(HIT-6)和匹兹堡睡眠质量指数量表(PSQI)进行评定。结果 在月经性偏头痛患者中,单纯焦虑或抑郁症状、焦虑抑郁症状共存、睡眠障碍的检出率均高于非月经性偏头痛患者(χ²=4.198、4.355、5.236、8.624,P<0.05或0.01),月经性偏头痛患者HAMA、HAMD-17、PSQI和HIT-6评分均高于非月经性偏头痛患者(Z=-3.550、-2.723、-2.482、-4.717,P<0.05或0.01)。相关分析显示,月经性偏头痛患者PSQI评分与HAMA评分(r=0.338,P<0.01)、HAMD-24评分(...     

Comprehensive assessment of the impact of life habits on sleep disturbance,chronotype, and daytime sleepiness among high-school students

ObjectiveSleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted.MethodsA cross-sectional survey of 344 high school students (age range 15–17; 171 boys, 173 girls) in Tokyo, Japan was conducted in 2015. Complete responses were provided by 294 students. Demographic variables, Pittsburgh Sleep Quality Index (PSQI), diurnal type scale, Pediatric Daytime Sleepiness Scale (PDSS), and life habits such as dinnertime, viewing electronic displays, caffeine intake, sunlight in the morning, and the brightness of the room in the night were asked.ResultsThe mean scores were PSQI: 5.9 (±2.3), PDSS: 19.0 (±5.8), and the diurnal type scale: 16.7 (±3.4). Using an electronic display in bed (OR = 3.01; (95%CI) 1.24–7.30), caffeine intake at night always (OR = 2.22; 1.01–4.90), and waking up before dawn (OR = 3.25; 1.34–7.88) were significantly associated with sleep disturbance. Irregular timing of the evening meal (OR = 2.06; 1.10–3.84) and display viewing within 2 h before bedtime (OR = 2.50; 1.01–6.18) or in bed (OR = 3.60; 1.41–9.21) were significantly associated with excessive daytime sleepiness. Using an electronic display within 2 h before bedtime (OR = 2.64; 1.10–6.38) or in bed (OR = 3.50; 1.40–8.76) and a living room which is bright at night (OR = 1.89; 1.06–3.36) were significantly associated with eveningness.ConclusionEach type of sleep-related problem had its own associated life habit factors.     

A seven day actigraphy-based study of rumination and sleep disturbance among young adults with depressive symptoms

Objectives

Trait ruminators exhibit significantly higher levels of sleep disturbance than those without this cognitive vulnerability. However, support for the sleep disruptive effects of state rumination, especially in the pre-sleep period, is rare, and hindered by methodological drawbacks such as self-report and single night assays of sleep. Finally, despite the pervasiveness of the ruminative response style among individuals with depression, the association between rumination and sleep disturbance has not been explored in this population. The present study employed a week-long daily sampling approach to examine the effects of naturally occurring pre-sleep rumination on self-reported and actigraphy-based sleep among individuals with high depressive symptomatology.

Methods

Forty-two university students (19.6 ± 3.2 yo;73.8% female), all of whom reported at least moderate levels of depressive symptoms, completed a short questionnaire after waking each morning for seven days. On this questionnaire, they self-reported sleep indices from the previous night and levels of engagement in pre-sleep rumination. Sleep was also monitored throughout this period via wrist actigraphy. Hierarchical-linear-modeling was used to examine the association between nightly rumination and sleep.

Results

Nightly variations in pre-sleep rumination were predictive of significantly longer actigraphy- and diary-based sleep onset latency (SOL). Notably, a 1 SD increase on the pre-sleep rumination scale was associated with an approximately 7 minute increase in actigraphy-based SOL, even after controlling for baseline sleep disturbance and depressive symptoms.

Conclusions

These data offer compelling evidence for the impact of pre-sleep rumination on sleep onset, providing insight into one potential mechanism that triggers sleep disturbance among individuals with depressive symptoms.     

Left superior temporal sulcus morphometry mediates the impact of anxiety and depressive symptoms on sleep quality in healthy adults

Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.     

Sleep quality versus sleep quantity: Relationships between sleep and measures of health, well-being and sleepiness in college students

Two studies assessed whether measures of health, well-being, and sleepiness are better related to sleep quality or sleep quantity. In both studies, subjects completed a 7-day sleep log followed by a battery of surveys pertaining to health, well-being, and sleepiness. In subjects sleeping an average of 7 hours a night, average sleep quality was better related to health, affect balance, satisfaction with life, and feelings of tension, depression, anger, fatigue, and confusion than average sleep quantity. In addition, average sleep quality was better related to sleepiness than sleep quantity. These results indicate that health care professionals should focus on sleep quality in addition to sleep quantity in their efforts to understand the role of sleep in daily life.     

Feasibility of electronic sleep disorder screening in healthcare workers of a large healthcare system

Study objectivesMany healthcare workers live with sleep disorders and may be unaware of their condition. We aimed to ascertain sleep disorder symptoms including high-risk obstructive sleep apnea (hrOSA), significant insomnia, and excessive daytime sleepiness (EDS) by work shift in a sample of healthcare workers. We aim to inform the development of a mobile application for sleep disorder screening and electronically-delivered follow-up recommendations.MethodsAn initial survey, including the Epworth Sleepiness Scale (ESS) for EDS, Insomnia Severity Scale (ISI) for insomnia, and STOP questionnaire for hrOSA, was completed by healthcare workers at the Cleveland Clinic. A follow-up survey sent ∼3–6 months after screening assessed perceptions of the utility of screening and subsequent actions taken by those with abnormal scores.Results871 of 2851 (30.7%) workers who participated had abnormal ESS scores, with a significantly greater portion of night shift workers with abnormal scores compared to day or evening shift workers (p < 0.001). 27.5% of all workers had moderate to severe insomnia symptoms, with higher percentages of moderate or severe scores in evening and night shift workers (p < 0.001). 36.9% of workers had hrOSA, and of those previously diagnosed with obstructive sleep apnea (OSA) and using positive airway pressure therapy, over 90% reported treatment adherence (≥4 h per night). At follow-up, 92% of 484 respondents believed that sleep screening was valuable, with most taking some action after receiving abnormal results and over a quarter seeking sleep center treatment.ConclusionsMany healthcare workers, especially shift workers, experience sleep disorder symptoms, and our findings suggest that electronic sleep disorder symptom screening is feasible.     

The interactive role of chronic medical conditions and sleep disturbance in predicting depressive symptoms among Korean American older adults

Objectives: This study examined the independent and interactive effects of chronic medical conditions and sleep disturbance on depressive symptomatology. The sample (N?=?675) consisted of community-dwelling Korean American older adults, a group that has been found to be particularly high in depressive symptomatology.

Methods: A hierarchical regression model of depressive symptoms was estimated with an array of predictors: (a) demographic variables, including immigration history, (b) chronic medical conditions, (c) sleep disturbance, and (d) an interaction between chronic medical conditions and sleep disturbance.

Results: After controlling for the effects of demographic variables, both chronic medical conditions and sleep disturbance were identified as independent risk factors for depressive symptoms. Moreover, their interaction was significant, indicating that the coexistence of chronic medical conditions and sleep disturbance was significantly associated with higher levels of depressive symptoms (β?=?0.15, p?

Conclusion: Our findings call attention to sleep hygiene among older individuals with chronic medical conditions and recommend that sleep quality should be closely monitored and assessed by healthcare professionals.     

Reciprocal dynamics between self-rated sleep and symptoms of depression and anxiety in young adult women: a 14-day diary study

ObjectivesThe objective of this study was to characterize the day-to-day associations among sleep disturbance, depression, and anxiety in a sample of young adult women.MethodsOne hundred and seventy-one women (20.1 ± 3.3 years) completed in-laboratory baseline assessment followed by daily online surveys across a two-week period. Daily measures included the Mood and Anxiety Symptom Questionnaire-Short Form to assess shared and disorder-specific symptoms of depression and anxiety (general distress, anhedonic depression, and anxious arousal), as well as self-reported total sleep time (TST), sleep-onset latency (SOL), and sleep quality (SQ).ResultsFindings supported bidirectional day-to-day relationships between sleep and affective symptoms. When women felt greater general distress (shared features of anxiety and depression), they experienced longer SOL and worse SQ at night. Specificity among depression, anxiety, and sleep disturbance was observed such that higher levels of depression-specific anhedonia presaged longer SOL, shorter TST, and poorer SQ. In the other direction, when women had poor-quality sleep, they later experienced greater anhedonic depression and anxious arousal. The influence of TST on anhedonia was complex such that a single night of short sleep led to less anhedonic depression the next day, whereas women who obtained shorter sleep across the two-week period reported greater anhedonia.ConclusionsReciprocal dynamics between nightly sleep disturbance and daily experiences of depression and anxiety may serve as a process by which insomnia, depression, and anxiety develop into comorbid clinical states over time in women. The associations of anhedonic depression with nightly sleep disturbance and chronic short sleep were especially toxic, offering insight into daily mechanisms driving the most prevalent phenotype of comorbid insomnia.     

强迫症状对强迫症患者睡眠的影响

目的了解无共病强迫症患者睡眠持续性和睡眠结构。方法采用随机数字表法选择2013年5月-2015年3月在无锡市精神卫生中心住院和门诊治疗的强迫症患者20例,同时纳入健康对照组20例,使用美国Embla多导睡眠监测仪监测研究对象睡眠持续性和睡眠结构。结果与对照组比较,强迫症患者非快速眼动睡眠4期时间减少(P0.05),快速眼动睡眠潜伏期缩短(P0.05),两组总睡眠时间、觉醒时间、快速眼动睡眠、睡眠效率等差异均无统计学意义(P均0.05)。OCD组Y-BOCS评分与总睡眠时间、睡眠效率呈负相关(r=-0.492,-0.543,P均0.05)。结论强迫症患者存在睡眠结构损害,强迫症状严重程度影响患者总睡眠时间和睡眠效率。