Riemann D, Berger M, Voderholzer U
Department of Psychiatry and Psychotherapy, University hospital of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany.
Biol Psychol. 2001 Jul-Aug;57(1-3):67-103. doi: 10.1016/s0301-0511(01)00090-4.
Disturbances of sleep are typical for most depressed patients and belong to the core symptoms of the disorder. Polysomnographic sleep research has demonstrated that besides disturbances of sleep continuity, in depression sleep is characterized by a reduction of slow wave sleep and a disinhibition of REM sleep, with a shortening of REM latency, a prolongation of the first REM period and increased REM density. These findings have stimulated many sleep studies in depressive patients and patients with other psychiatric disorders. In the meantime, several theoretical models, originating from basic research, have been developed to explain sleep abnormalities of depression, like the two-process-model of sleep and sleep regulation, the GRF/CRF imbalance model and the reciprocal interaction model of non-REM and REM sleep regulation. Interestingly, most of the effective antidepressant agents suppress REM sleep. Furthermore, manipulations of the sleep-wake cycle, like sleep deprivation or a phase advance of the sleep period, alleviate depressive symptoms. These data indicate a strong bi-directional relationship between sleep, sleep alterations and depression.
睡眠障碍是大多数抑郁症患者的典型症状，属于该疾病的核心症状。多导睡眠图睡眠研究表明，除了睡眠连续性障碍外，抑郁症患者的睡眠特征还包括慢波睡眠减少和快速眼动睡眠去抑制，快速眼动潜伏期缩短，首个快速眼动期延长以及快速眼动密度增加。这些发现激发了许多针对抑郁症患者及其他精神疾病患者的睡眠研究。与此同时，基于基础研究已开发出多种理论模型来解释抑郁症的睡眠异常，如睡眠与睡眠调节的双过程模型、促肾上腺皮质激素释放因子/促肾上腺皮质激素释放激素失衡模型以及非快速眼动和快速眼动睡眠调节的相互作用模型。有趣的是，大多数有效的抗抑郁药会抑制快速眼动睡眠。此外，对睡眠 - 觉醒周期的操控，如睡眠剥夺或睡眠时间提前，可缓解抑郁症状。这些数据表明睡眠、睡眠改变与抑郁症之间存在强烈的双向关系。
