Nutt David, Wilson Sue, Paterson Louise
Psychopharmacology Unit, University of Bristol, UK.
Dialogues Clin Neurosci. 2008;10(3):329-36. doi: 10.31887/DCNS.2008.10.3/dnutt.
Links between sleep and depression are strong. About three quarters of depressed patients have insomnia symptoms, and hypersomnia is present in about 40% of young depressed adults and 10% of older patients, with a preponderance in females. The symptoms cause huge distress, have a major impact on quality of life, and are a strong risk factor for suicide. As well as the subjective experience of sleep symptoms, there are well-documented changes in objective sleep architecture in depression. Mechanisms of sleep regulation and how they might be disturbed in depression are discussed. The sleep symptoms are often unresolved by treatment, and confer a greater risk of relapse and recurrence. Epidemiological studies have pointed out that insomnia in nondepressed subjects is a risk factor for later development of depression. There is therefore a need for more successful management of sleep disturbance in depression, in order to improve quality of life in these patients and reduce an important factor in depressive relapse and recurrence.
睡眠与抑郁症之间的联系十分紧密。约四分之三的抑郁症患者有失眠症状，约40%的年轻抑郁症成年人及10%的老年患者存在嗜睡症状，女性更为多见。这些症状会造成巨大痛苦，对生活质量有重大影响，且是自杀的重要危险因素。除了睡眠症状的主观体验外，抑郁症患者的客观睡眠结构也有充分记录的变化。本文讨论了睡眠调节机制以及它们在抑郁症中可能如何受到干扰。睡眠症状往往在治疗后仍未得到解决，且会带来更高的复发风险。流行病学研究指出，非抑郁症患者的失眠是日后患抑郁症的一个危险因素。因此，需要更成功地管理抑郁症患者的睡眠障碍，以改善这些患者的生活质量，并减少抑郁症复发和再发的一个重要因素。
