Kaplan Katherine A, Harvey Allison G
Department of Psychology, University of California-Berkeley, Berkeley, CA 94720-1650, USA.
Sleep Med Rev. 2009 Aug;13(4):275-85. doi: 10.1016/j.smrv.2008.09.001. Epub 2009 Mar 9.
Hypersomnia is prevalent and persistent across mood disorders. This review has two aims: (1) to synthesize the research that has accrued on hypersomnia in mood disorders and (2) to identify an agenda for future research that advances knowledge on this critical, but understudied, feature of mood disorders. We begin by reviewing the state-of-the-science on the diagnosis, epidemiology and course of hypersomnia in Major Depressive Disorder, Bipolar Disorder, Dysthymic Disorder, and Seasonal Affective Disorder. We then address key measurement and assessment issues, particularly those arising from the use of objective methods. This section identifies a need to explore whether hypersomnia is a disorder of Time in Bed (TIB) rather than a disorder of Total Sleep Time (TST), or whether presentations of TIB vs. TST represent two subtypes of hypersomnia with differing etiologies. Established and proposed mechanisms contributing to hypersomnia are then highlighted, including the possibility that hypersomnia is an important mechanism contributing to the maintenance of mood disorder symptoms. We then move on to review the small body of literature on pharmacological interventions for hypersomnia in mood disorders. Though non-pharmacological treatments targeting hypersomnia have not yet been developed, we offer initial guidelines for such treatments and conclude with an agenda for future research.
嗜睡症在情绪障碍中普遍且持续存在。本综述有两个目的：（1）综合已积累的关于情绪障碍中嗜睡症的研究；（2）确定未来研究议程，以推进对情绪障碍这一关键但研究不足的特征的认识。我们首先回顾关于重度抑郁症、双相情感障碍、恶劣心境障碍和季节性情感障碍中嗜睡症的诊断、流行病学和病程的科学现状。然后我们讨论关键的测量和评估问题，特别是那些因使用客观方法而产生的问题。本节指出有必要探讨嗜睡症是卧床时间（TIB）的障碍而非总睡眠时间（TST）的障碍，或者TIB与TST的表现是否代表具有不同病因的两种嗜睡症亚型。接着强调了导致嗜睡症的既定和提出的机制，包括嗜睡症可能是导致情绪障碍症状维持的重要机制。然后我们继续回顾关于情绪障碍中嗜睡症的药物干预的少量文献。尽管尚未开发出针对嗜睡症的非药物治疗方法，但我们提供了此类治疗的初步指南，并以未来研究议程作为总结。
