Parry B L, Mostofi N, LeVeau B, Nahum H C, Golshan S, Laughlin G A, Gillin J C
Department of Psychiatry, University of California, San Diego, La Jolla 92093-0804, USA.
Psychiatry Res. 1999 Feb 22;85(2):127-43. doi: 10.1016/s0165-1781(98)00128-0.
In this study of 23 patients with premenstrual dysphoric disorder (PMDD) and 18 normal comparison (NC) subjects, we examined sleep EEG measures during baseline midfollicular (MF) and late luteal (LL) menstrual cycle phases and after early sleep deprivation (ESD), in which subjects slept from 03.00 to 07.00 h, and late sleep deprivation (LSD), in which subjects slept from 21.00 to 01.00 h. Each sleep deprivation night was followed by a night of recovery sleep (ESD-R, LSD-R) (sleep 22.30-06.30 h) and was administered in the late luteal phase of separate menstrual cycles. During baseline studies, sleep EEG measures differed significantly by menstrual cycle phase, but not group. Both PMDD and NC groups showed longer REM latencies and less REM sleep (minutes and percent) during the luteal compared with the follicular menstrual cycle phase. PMDD subjects, however, did not show sleep architecture changes similar to those of patients with major depressive disorders. Sleep quality was better during recovery nights of sleep in PMDD compared with NC subjects. REM sleep measures changed in association with clinical improvement in responders to sleep deprivation. Both early and late sleep deprivation may help to correct underlying circadian rhythm disturbances during sleep in PMDD, although differential sleep changes during ESD vs. LSD did not correlate with clinical response. Further sleep studies addressing additional circadian variables may serve to elucidate mechanisms mediating the therapeutic effects of sleep deprivation in PMDD.
在这项针对23名经前烦躁障碍（PMDD）患者和18名正常对照（NC）受试者的研究中，我们检测了在卵泡中期（MF）和黄体晚期（LL）月经周期阶段的基线期以及早期睡眠剥夺（ESD，受试者在03:00至07:00 h睡眠）和晚期睡眠剥夺（LSD，受试者在21:00至01:00 h睡眠）后的睡眠脑电图指标。每个睡眠剥夺夜晚之后是一晚的恢复睡眠（ESD-R、LSD-R）（睡眠时段为22:30至06:30 h），且在不同月经周期的黄体晚期进行。在基线研究期间，睡眠脑电图指标在月经周期阶段存在显著差异，但在组间无差异。与卵泡期月经周期阶段相比，PMDD组和NC组在黄体期均表现出更长的快速眼动（REM）潜伏期和更少的REM睡眠（分钟数和百分比）。然而，PMDD受试者并未表现出与重度抑郁症患者相似的睡眠结构变化。与NC受试者相比，PMDD受试者在恢复睡眠夜晚的睡眠质量更好。REM睡眠指标的变化与睡眠剥夺反应者的临床改善相关。早期和晚期睡眠剥夺均可能有助于纠正PMDD患者睡眠期间潜在的昼夜节律紊乱，尽管ESD与LSD期间不同的睡眠变化与临床反应无关。针对其他昼夜变量的进一步睡眠研究可能有助于阐明介导睡眠剥夺对PMDD治疗作用的机制。
