Jaimchariyatam Nattapong, Rodriguez Carlos L, Budur Kumar
Dr. Jaimchariyatam is from the Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand, Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand, and Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio;
Innov Clin Neurosci. 2011 Jul;8(7):35-49.
Objective. Major depressive disorder is associated with sleep disturbances. An electroencephalographic pattern of alpha wave intrusion in delta wave sleep (alpha-delta sleep) is observed in some subjects with major depressive disorder. The treatment-resistant symptoms in major depressive disorder, nonrestorative sleep and fatigue, are associated with alpha-delta sleep. The objective of this study is to identify the prevalence and clinical correlates of alpha-delta sleep in major depressive disorder.Design. Retrospective studySetting. Sleep Disorders Center, Cleveland Clinic, Cleveland, OhioParticipants. Polysomnograms were conducted on 150 subjects 18 years of age or older (75 with and 75 without major depressive disorder) were reviewed.Measurements. The percent of delta waves with alpha intrusion was collected and analyzed.Results. Subjects with major depressive disorder compared to nondepressed subjects had a higher sleep efficiency (83.0±9.6; 78.1±8.2%), shorter rapid eye movement latency (85.0±44.5; 189.9±25.6 min), less slow wave sleep (8.3±3.0; 13.5±6.2%), and greater rapid eye movement (24.7±7.0; 19.2±8.2%), and all of these findings were statistically significant. Patients with major depressive disorder had higher alpha-delta sleep (23.4±14.2%; 2.3±6.7%, p<0.01). Patients with major depressive disorder were categorized into high and low alpha-delta sleep based on percentage of alpha-delta sleep present in slow wave sleep (alpha-delta sleep was present ≥15% or ≤15% of slow wave sleep, respectively). Patients with major depressive disorder with high alpha-delta sleep were at 3.15 greater odds (1.22-8.14; p=0.018) to have excessive daytime sleepiness.Conclusion. Patients with major depressive disorder have a higher prevalence of alpha-delta sleep. Alpha-delta sleep is associated with daytime sleepiness in patients with major depressive disorder. Study limitations include the retrospective nature of the project and the fact that the principle investigator, who scored and interpreted alpha intrusion, was not blind to group membership.
目的。重度抑郁症与睡眠障碍有关。在一些重度抑郁症患者中观察到了在慢波睡眠中出现α波侵入的脑电图模式（α-δ睡眠）。重度抑郁症中难治性症状、非恢复性睡眠和疲劳与α-δ睡眠有关。本研究的目的是确定重度抑郁症中α-δ睡眠的患病率及其临床相关性。
设计。回顾性研究
地点。俄亥俄州克利夫兰市克利夫兰诊所睡眠障碍中心
参与者。对150名18岁及以上的受试者（75名患有重度抑郁症，75名未患重度抑郁症）的多导睡眠图进行了回顾。
测量。收集并分析伴有α波侵入的慢波百分比。
结果。与非抑郁症患者相比，重度抑郁症患者的睡眠效率更高（83.0±9.6；78.1±8.2%），快速眼动潜伏期更短（85.0±44.5；189.9±25.6分钟），慢波睡眠更少（8.3±3.0；13.5±6.2%），快速眼动更多（快眼动睡眠更多（24.7±7.0；19.2±8.2%），所有这些结果在统计学上均具有显著性。重度抑郁症患者的α-δ睡眠更高（23.4±14.2%；2.3±6.7%，p<0.01）。根据慢波睡眠中α-δ睡眠的百分比，将重度抑郁症患者分为高α-δ睡眠组和低α-δ睡眠组（α-δ睡眠分别占慢波睡眠的≥15%或≤15%）。高α-δ睡眠的重度抑郁症患者出现日间过度嗜睡的几率高3.15倍（1.22 - 8.14；p = 0.018）。
结论。重度抑郁症患者中α-δ睡眠的患病率更高。α-δ睡眠与重度抑郁症患者的日间嗜睡有关。研究局限性包括该项目的回顾性性质以及对α波侵入进行评分和解读但不了解分组情况的主要研究者。
