Third Department of Psychiatry, Institute of Psychiatry and Neurology , Warsaw , Poland.
Int Rev Psychiatry. 2013 Oct;25(5):632-45. doi: 10.3109/09540261.2013.812067.
Sleep is a complex biological process that involves cyclic changes of brain activity. The smooth transition between wakefulness and sleep and cyclic succession of sleep stages depend on the function of numerous neurotransmitters that reciprocally influence each other. For this reason sleep is a very sensitive biomarker of brain functioning. This article provides an overview of sleep changes in depression, mechanisms involved in sleep regulation and pathophysiology underlying depression, studies on sleep as a biomarker for depression, effects of antidepressants on sleep EEG, and studies in depression with the use of quantitative sleep EEG analysis. Research on sleep in depression has provided several valuable biomarkers that are related to increased risk for depression, show worsening during depressive episode, and are related to treatment outcome and relapse risk during remission phase. Among many sleep parameters, increased REM density and diminished delta sleep ratio deserve special interest. Sleep studies are also an important research tool for antidepressant drug development. However, due to sensitivity of sleep parameters to pharmacological interventions, the patients have to be investigated before the start of pharmacological treatment or after washout from the antidepressant drug, to obtain reliable data on disease-related biological processes from polysomnography.
睡眠是一个复杂的生物过程，涉及大脑活动的周期性变化。从清醒到睡眠的平稳过渡和睡眠阶段的周期性连续，取决于众多相互影响的神经递质的功能。因此，睡眠是大脑功能的一个非常敏感的生物标志物。本文概述了抑郁症中的睡眠变化、睡眠调节机制和抑郁症的病理生理学基础、睡眠作为抑郁症生物标志物的研究、抗抑郁药对睡眠 EEG 的影响，以及使用定量睡眠 EEG 分析在抑郁症中的研究。对抑郁症睡眠的研究提供了几个有价值的生物标志物，这些标志物与抑郁症的发病风险增加有关，在抑郁发作期间恶化，与缓解期的治疗效果和复发风险有关。在众多睡眠参数中，快速眼动密度增加和 delta 睡眠比值降低值得特别关注。睡眠研究也是抗抑郁药物开发的重要研究工具。然而，由于睡眠参数对药物干预的敏感性，在开始药物治疗之前或从抗抑郁药物洗脱后，患者必须进行检查，以便从多导睡眠图中获得与疾病相关的生物过程的可靠数据。
