强迫症患者睡眠特征初步探讨

背景强迫症患者睡眠参数与正常人及强迫症患病时期有何关系?揭示强迫症患者的睡眠特征是目前睡眠研究中的热点.目的探讨并分析强迫症患者异常睡眠现象与睡眠特征的关系. 设计以诊断为依据的病例对照研究.地点、对象和方法全部病例为宁波市康宁医院门诊和住院的强迫症患者,共21例,对照组为浙江宁波市康宁医院职工、家属和进修生 20例,均为自愿参加研究.对强迫症患者进行多导睡眠图(polysomnogram,PSG)检查,并与对照组进行对比分析. 主要观察指标两组受检者睡眠进程、睡眠结构和快速眼动期睡眠(rapid eye movement,REM)各指标. 结果强迫症患者全夜中睡眠觉醒次数、觉醒总时间(平均32.95次, 73.26 min)比对照组多(平均 11.46次 ,18.97 min)( t=6.55, 1.16,P< 0.01);睡眠效率下降(对照组、强迫症组平均分别为 91.44%, 86.70% )( t=0.79, P< 0.05);非快速眼动期睡眠(NREM)第 1期( S1期)百分比减少 (对照组平均为 6.23%,强迫症组平均为4.00% )(t=0.89, P< 0.05); REM时间增加 (对照组平均为 18.10 min,强迫症组平均为68.86 min)(t=1.73, P< 0.05).强迫症患者的病程与 REM睡眠首次潜伏期呈正相关(r=0.57, P< 0.01),与 REM睡眠时间呈负相关 (r=- 0.60, P< 0.01),即随着强迫症患者的病程增长,REM睡眠的首次潜伏期时间后移,而 REM睡眠时间减少. 结论强迫症患者的异常睡眠现象,可能与发病机制有关.

Preliminary study onsleep features in patients with obsessive-compulsive disorder

BACKGROUND: What is the relationship between sleep parameters of patients with obsessive-compulsive disorder(OCD) and the healthy person and different disorder stages? Disclosing the sleep features in patients with OCD has been the focus of the present study on sleep. OBJECTIVE: To explore and analyze the connection between abnormal sleep and sleep features in patients with OCD. DESIGN: Diagnosis-based case control study. SETTING,SUBJECTS AND METHODS: The 21 cases of OCD selected were hospitalized patients and outpatients of Kangning Hospital in Ningbo City,Zhejiang Province. In the control group,the 20 volunteers were the employees,family members and postgraduate students of the hospital. Polysomnogram(PSG) was performed on the OCD patients and the results were compared with those of the controls. MAIN OUTCOME MEASURES: Parameters of sleep course, sleep structure, and rapid eye movement(REM) were measured in both groups. RESULTS: In OCD patients,all-night waking times and total waking minutes( mean 32.95 times, 73.26min) were more than those of controls( mean 11.46 times, 18.97min) (t=6.55, 1.16, P< 0.01); sleep efficiency fell(mean value in controls and patients was 91.44% and 86.70% , respectively)( t=0.79, P < 0.05); stage 1( S1) percentage of nonrapid eye movement(NREM) reduced(mean value in controls and patients was 6.23% and 4.00% ) (t=0.89, P< 0.05);REM time increased(mean value in controls and OCD group was 18.10 min and 68.86 min,respectively) (t=1.73, P< 0.05).The course of disease was positively correlated with the first latent period of REM sleep(r=0.57, P< 0.01), but negatively correlated with REM sleep time(r=- 0.60, P< 0.01).That is,with the increase of disease course in OCD patients, the first latent period in REM sleep was delayed, but REM sleep time was reduced. CONCLUSION: Abnormal sleep in patients with obsessive-compulsive disorder may be associated with the pathogenesis.