Takaesu Yoshikazu, Ishikawa Jun, Komada Yoko, Murakoshi Akiko, Futenma Kunihiro, Nishida Shingo, Inoue Yuichi
Department of Psychiatry and bDepartment of Somnology, Tokyo Medical University, Japan.
Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo.
J Clin Psychiatry. 2016 Jul;77(7):e892-8. doi: 10.4088/JCP.15m10055.
To clarify the prevalence and clinical features of sleep-related eating disorder (SRED) in psychiatric outpatients taking hypnotics as well as factors associated with the disorder.
From February 1, 2012, to February 29, 2012, a cross-sectional study was undertaken. A questionnaire addressing demographics, the Japanese version of the Pittsburgh Sleep Quality Index (PSQI), presence of abnormal behavior during sleep focusing on SRED and sleepwalking, and duration of hypnotic medication and subjective side effects of the drug was distributed to psychiatric outpatients who were taking hypnotics at the time of the survey.
Of 1,318 patients taking hypnotics, 1,048 patients (79.5%) provided valid responses, and 88 of them (8.4%) had experienced SRED. The SRED group was significantly younger, had a significantly higher total PSQI score, and took higher bedtime diazepam-equivalent doses of hypnotics than the non-SRED group (P < .01 for all comparisons). In the SRED group, subjective side effects due to hypnotics were present at significantly higher proportions than in the non-SRED group. Multiple logistic regression analysis showed that younger age (adjusted odds ratio [aOR] = 0.98, 95% CI = 0.96-0.99, P = .021), taking 2 or more kinds of antipsychotics (aOR = 3.41, 95% CI = 1.93-6.05, P < .001), and the bedtime diazepam-equivalent dose of a hypnotic (aOR = 1.03, 95% CI = 1.01-1.05, P = .039) were significantly associated with the experience of SRED.
The prevalence of SRED in psychiatric outpatients taking hypnotics is elevated, particularly in younger patients, and the hypnosedative effects of the drugs could be responsible for the occurrence of the disorder in this population.
明确服用催眠药的精神科门诊患者中与睡眠相关进食障碍（SRED）的患病率及临床特征，以及与该障碍相关的因素。
于2012年2月1日至2012年2月29日进行一项横断面研究。向调查时正在服用催眠药的精神科门诊患者发放一份问卷，内容涉及人口统计学信息、匹兹堡睡眠质量指数（PSQI）日语版、以SRED和梦游为重点的睡眠期间异常行为的存在情况，以及催眠药用药时长和药物主观副作用。
在1318名服用催眠药的患者中，1048名患者（79.5%）提供了有效回复，其中88名（8.4%）曾经历过SRED。SRED组患者明显更年轻，PSQI总分显著更高，且睡前服用地西泮等效剂量的催眠药比非SRED组更高（所有比较P <.01）。在SRED组中，因催眠药导致的主观副作用出现比例明显高于非SRED组。多因素逻辑回归分析显示，年龄较小（调整优势比[aOR]=0.98，95%可信区间[CI]=0.96 - 0.99，P =.021）、服用2种或更多种抗精神病药物（aOR = 3.41，95%CI = 1.93 - 6.05，P <.001）以及催眠药的睡前地西泮等效剂量（aOR = 1.03，95%CI = 1.01 - 1.05，P =.039）与SRED经历显著相关。
服用催眠药的精神科门诊患者中SRED的患病率升高，尤其是在年轻患者中，药物的催眠镇静作用可能是该人群中该障碍发生的原因。
