Toffol Elena, Kalleinen Nea, Urrila Anna Sofia, Himanen Sari-Leena, Porkka-Heiskanen Tarja, Partonen Timo, Polo-Kantola Päivi
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, P,O, Box 30, Helsinki FI-00271, Finland.
BMC Psychiatry. 2014 Jun 16;14:177. doi: 10.1186/1471-244X-14-177.
Sleep is disrupted in depressed subjects, but it also deteriorates with age and possibly with the transition to menopause. The nature of interaction between mood, sleep, age and reproductive state is not well-defined. The aim of this study was to evaluate the relationship between mood and sleep among healthy women in different reproductive states.
We analyzed data from 11 younger (20-26 years), 21 perimenopausal (43-51 years) and 29 postmenopausal (58-71 years) healthy women who participated in a study on menopause, sleep and cognition. The 21-item Beck Depression Inventory (BDI) was administered to assess mood. Subjective sleep quality was assessed with the Basic Nordic Sleep Questionnaire (BNSQ). Objective sleep was measured with all-night polysomnography (PSG) recordings. Perimenopausal and younger women were examined during the first days of their menstrual cycle at the follicular phase.
Among younger women, less arousals associated with higher BDI total scores (p = 0.026), and higher SWS percentages with more dissatisfaction (p = 0.001) and depressive-somatic symptoms (p = 0.025), but with less depressive-emotional symptoms (p = 0.001). In specific, less awakenings either from REM sleep or SWS, respectively, associated with more punishment (p = 0.005; p = 0.036), more dissatisfaction (p < 0.001; p = 0.001) and more depressive-somatic symptoms (p = 0.001; p = 0.009), but with less depressive-emotional symptoms (p = 0.002; p = 0.003). In perimenopausal women, higher BNSQ insomnia scores (p = 0.005), lower sleep efficiencies (p = 0.022) and shorter total sleep times (p = 0.024) associated with higher BDI scores, longer sleep latencies with more depressive-somatic symptoms (p = 0.032) and longer REM latencies with more dissatisfaction (p = 0.017). In postmenopausal women, higher REM percentages associated with higher BDI total scores (p = 0.019) and more depressive-somatic symptoms (p = 0.005), and longer SWS latencies with more depressive-somatic symptoms (p = 0.030).
Depressive symptoms measured with the total BDI scores associated with sleep impairment in both perimenopausal and postmenopausal women. In younger women, specific BDI factors revealed minor associations, suggesting that the type of sleep impairment can vary in relation to different depressive features. Our data indicate that associations between sleep and depressed mood may change in conjunction with hormonal milestones.
抑郁症患者的睡眠受到干扰，但睡眠也会随着年龄增长以及可能随着向更年期的过渡而恶化。情绪、睡眠、年龄和生殖状态之间相互作用的本质尚未明确界定。本研究的目的是评估处于不同生殖状态的健康女性的情绪与睡眠之间的关系。
我们分析了11名年轻（20 - 26岁）、21名围绝经期（43 - 51岁）和29名绝经后（58 - 71岁）参与更年期、睡眠与认知研究的健康女性的数据。采用21项贝克抑郁量表（BDI）评估情绪。用基本北欧睡眠问卷（BNSQ）评估主观睡眠质量。通过整夜多导睡眠图（PSG）记录测量客观睡眠。围绝经期和年轻女性在月经周期卵泡期的头几天接受检查。
在年轻女性中，觉醒次数越少与BDI总分越高相关（p = 0.026），慢波睡眠（SWS）百分比越高与更多不满情绪（p = 0.001）和抑郁躯体症状（p = 0.025）相关，但与抑郁情绪症状越少相关（p = 0.001）。具体而言，快速眼动睡眠（REM）或SWS中醒来次数越少，分别与更多惩罚感（p = 0.005；p = 0.036）、更多不满情绪（p < 0.001；p = 0.001）和更多抑郁躯体症状（p = 0.001；p = 0.009）相关，但与抑郁情绪症状越少相关（p = 0.002；p = 0.003）。在围绝经期女性中，BNSQ失眠得分越高（p = 0.005）、睡眠效率越低（p = 0.022）和总睡眠时间越短（p = 0.024）与BDI得分越高相关，入睡潜伏期越长与更多抑郁躯体症状相关（p = 0.032），REM潜伏期越长与更多不满情绪相关（p = 0.017）。在绝经后女性中，REM百分比越高与BDI总分越高（p = 0.019）和更多抑郁躯体症状相关（p = 0.005），SWS潜伏期越长与更多抑郁躯体症状相关（p = 0.030）。
用BDI总分测量的抑郁症状与围绝经期和绝经后女性的睡眠障碍相关。在年轻女性中，特定的BDI因素显示出较小的关联，表明睡眠障碍的类型可能因不同的抑郁特征而异。我们的数据表明，睡眠与抑郁情绪之间的关联可能会随着激素里程碑而变化。
