Franzen Peter L, Buysse Daniel J
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Dialogues Clin Neurosci. 2008;10(4):473-81. doi: 10.31887/DCNS.2008.10.4/plfranzen.
The majority of individuals with depression experience sleep disturbances. Depression is also over-represented among populations with a variety of sleep disorders. Although sleep disturbances are typical features of depression, such symptoms sometimes appear prior to an episode of depression. The bidirectional associations between sleep disturbance (especially insomnia) and depression increase the difficulty of differentiating cause-and-effect relationships between them. Longitudinal studies have consistently identified insomnia as a risk factor for the development of a new-onset or recurrent depression, and this association has been identified in young, middle-aged, and older adults. Studies have also observed that the combination of insomnia and depression influences the trajectory of depression, increasing episode severity and duration as well as relapse rates. Fortunately, recent studies have demonstrated that both pharmacological and nonpharmacological interventions for insomnia may favorably reduce and possibly prevent depression. Together, these findings suggest that sleep-related symptoms that are present before, during, andlor after a depressive episode are potentially modifiable factors that may play an important role in achieving and maintaining depression remission.
大多数抑郁症患者会出现睡眠障碍。在患有各种睡眠障碍的人群中，抑郁症的发病率也偏高。虽然睡眠障碍是抑郁症的典型特征，但这些症状有时会在抑郁发作之前出现。睡眠障碍（尤其是失眠）与抑郁症之间的双向关联增加了区分两者因果关系的难度。纵向研究一致认为失眠是新发或复发性抑郁症发生的一个危险因素，并且这种关联在年轻人、中年人和老年人中均有发现。研究还观察到，失眠与抑郁症的合并会影响抑郁症的病程，增加发作的严重程度和持续时间以及复发率。幸运的是，最近的研究表明，针对失眠的药物和非药物干预都可能有效地减轻甚至预防抑郁症。这些研究结果共同表明，在抑郁发作之前、期间和/或之后出现的与睡眠相关的症状是潜在的可调节因素，可能在实现和维持抑郁症缓解方面发挥重要作用。
