重性抑郁发作中的失眠和嗜睡：基于人群的研究中的患病率、社会人口学特征和精神共病。
Insomnia and hypersomnia in major depressive episode: Prevalence, sociodemographic characteristics and psychiatric comorbidity in a population-based study.
机构信息
Inserm, U1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique, 75475 Paris cedex 10, France; Fondation FondaMental, Créteil 94000, France.
Assistance Publique-Hôpitaux de Paris (APHP), Corentin Celton Hospital, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France.
出版信息
J Affect Disord. 2018 Jan 15;226:132-141. doi: 10.1016/j.jad.2017.09.032. Epub 2017 Sep 25.
OBJECTIVES
To examine (i) the frequency of different sleep complaints (early wake-up, trouble falling asleep, hypersomnia) and their co-occurrence and (ii) the sociodemographic characteristics and psychiatric comorbidity associated with each type of sleep profiles.
METHODS
Data were drawn from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of the US adult population (wave 1, 2001-2002; wave 2, 2004-2005). The primary analyses were limited to 3573 participants who had a DSM-IV-TR diagnosis of major depressive episode (MDE) between the two waves. We used a multiple regression model to estimate the strength of independent associations between self-reported sleep complaints, sociodemographic characteristics and lifetime psychiatric comorbidity.
RESULTS
Most of participants with MDE (92%) reported significant sleep complaints, from whom 85.2% had insomnia and 47.5% hypersomnia symptoms. The prevalence rates were for insomnia "only" of 48.5%, hypersomnia "only" of 13.7%, and their co-occurrence of 30.2%. We found that several sociodemographic characteristics (gender, age, education, individual and familial income, marital status) and psychiatric disorders (bipolar disorders, post-traumatic disorders and panic disorder) were significantly and independently associated with different sleep profiles. The co-occurrence of insomnia (especially early wake-up) and hypersomnia presented with a two-/three- fold increase risk of bipolar disorders.
LIMITATIONS
Definitions of sleep complaints were qualitative and subjective.
CONCLUSION
Sleep complaints are prevalent and heterogeneous in expression during MDE. Sleep disturbance profiles are associated with specific patterns of comorbidity. Our findings highlight the importance of continued research on sleep complaints during MDE while taking into account psychiatric comorbidity.
目的
（i）检查不同睡眠问题（早醒、入睡困难、嗜睡）的发生频率及其共病情况，以及（ii）与每种睡眠类型相关的社会人口学特征和精神共病。
方法
数据来自全国酒精相关条件流行病学调查第 2 波，这是一项对美国成年人群体的全国代表性调查（第 1 波，2001-2002 年；第 2 波，2004-2005 年）。主要分析仅限于在两次调查之间患有 DSM-IV-TR 诊断的重性抑郁发作（MDE）的 3573 名参与者。我们使用多元回归模型来估计自我报告的睡眠问题、社会人口学特征和终生精神共病之间的独立关联强度。
结果
大多数患有 MDE 的参与者（92%）报告有明显的睡眠问题，其中 85.2%有失眠症状，47.5%有嗜睡症状。失眠“仅”的患病率为 48.5%，嗜睡“仅”的患病率为 13.7%，两者共病的患病率为 30.2%。我们发现，一些社会人口学特征（性别、年龄、教育程度、个人和家庭收入、婚姻状况）和精神障碍（双相障碍、创伤后应激障碍和惊恐障碍）与不同的睡眠类型显著且独立相关。失眠（尤其是早醒）和嗜睡的共病使双相障碍的风险增加了两到三倍。
局限性
睡眠问题的定义是定性和主观的。
结论
在 MDE 期间，睡眠问题普遍存在且表现各异。睡眠障碍模式与特定的共病模式相关。我们的研究结果强调了在考虑精神共病的情况下，继续研究 MDE 期间睡眠问题的重要性。
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