Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA.
Curr Psychiatry Rep. 2009 Dec;11(6):437-42. doi: 10.1007/s11920-009-0066-1.
Historically, insomnia has been viewed as a symptom of depressive illness that is expected to resolve with adequate treatment of the depressive disorder. This article reviews the evidence that increasingly challenges this simplistic view and summarizes research demonstrating the multifaceted interplay between insomnia and depression. It discusses the prevalence, clinical significance, and time course of insomnia, distinguishing between poor sleep and an insomnia disorder. The article also discusses abnormalities in sleep architecture in major depressive disorder and theories about the pathways connecting sleep and depression. It concludes with a discussion of issues related to treatment, including the effects of antidepressants on sleep and new evidence of the utility of adding an insomnia-specific therapy for improved management of depressed patients with comorbid insomnia.
从历史上看，失眠被视为抑郁障碍的症状，预计随着抑郁障碍的充分治疗，失眠会得到缓解。本文回顾了越来越多的证据，这些证据对这种简单的观点提出了挑战，并总结了研究表明失眠和抑郁之间多方面相互作用的研究。它讨论了失眠的患病率、临床意义和时间进程，区分了睡眠质量差和失眠症。本文还讨论了重性抑郁障碍中睡眠结构的异常以及关于连接睡眠和抑郁的途径的理论。最后讨论了与治疗相关的问题，包括抗抑郁药对睡眠的影响以及为改善共病失眠的抑郁患者的管理而增加专门治疗失眠的新证据。
