Sleep Laboratory, Forenap, Centre Hospitalier de Rouffach, 27 rue du 4ème R.S.M. F-68250 Rouffach, France.
Sleep Med Rev. 2010 Feb;14(1):35-46. doi: 10.1016/j.smrv.2009.09.003. Epub 2009 Nov 25.
During the last decade, several studies have shown that insomnia, rather than a symptom of depression, could be a medical condition on its own, showing high comorbidity with depression. Epidemiological research indicates that insomnia could lead to depression and/or that common causalities underlie the two disorders. Neurobiological and sleep EEG studies suggest that a heightened level of arousal may play a common role in both conditions and that signs of REM sleep disinhibition may appear in individuals prone to depression. The effects of antidepressant drugs on non-REM and REM sleep are discussed in relation to their use in insomnia comorbid with depression. Empirical treatment approaches are behavioral management of sleep combined with prescription of a sedative antidepressant alone, co-prescription of two antidepressants, or of an antidepressant with a hypnotic drug.
在过去的十年中，有几项研究表明，失眠症本身就可能是一种医学病症，而非抑郁的症状，它与抑郁症的共病率很高。流行病学研究表明，失眠症可能导致抑郁症，或者两种疾病的发病基础相同。神经生物学和睡眠脑电图研究表明，觉醒水平升高可能在这两种疾病中起共同作用，并且容易患抑郁症的个体可能会出现 REM 睡眠抑制的迹象。本文还讨论了抗抑郁药对非快速眼动睡眠和快速眼动睡眠的影响，以及它们在与抑郁共病的失眠症中的应用。实证治疗方法包括对睡眠进行行为管理，单独开镇静抗抑郁药，或者联合开两种抗抑郁药，或者开一种抗抑郁药加催眠药。
