Cai Liqiang, You Yafeng, Wei Lili, Qin Yanhua, Yao Jiashu, Sun Yi, Zhang Lisan, Chen Wei
Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Center for Sleep Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 Aug 25;49(4):462-467. doi: 10.3785/j.issn.1008-9292.2020.08.16.
To investigate the relationship between sleep parameters and suicidal ideation in patients with late-life depression (LLD).
Seventy-seven LLD patients over 60 years old from Sir Run Run Shaw Hospital of Zhejiang University during July 2017 and July 2018 were included in the study. All patients were assessed with Hamilton Depression Rating Scale (HAMD) and polysomnography (PSG) overnight. The suicidal score of item 3 in HAMD (HAM-D3)was used to define whether there was a suicidal ideation. Participants were subsequently grouped according to endorsement of presence (HAM-D3 score ≥1, =46) versus absence (HAM-D3 score=0, =31) of suicidal ideation symptoms. The sleep efficiency, total sleep time, wakefulness after sleep onset, rapid eye movement percent/latency, and non-rapid eye movement sleep stages 1-3 (N1-N3) were assessed. ANOVA analyses were conducted to explore the correlation of sleep parameters with suicidal ideation between the groups with and without suicidal ideation. In model 1, the HAM-D3 constituted the independent variable in separate ANOVA tests; in model 2 the impact of depressive symptoms were assessed as a covariate with sleep parameters.
There was less stage N3 [(55±41)min, =-4.731, <0.05] and the reduced percentage of N3 [(15±11)%, =-4.194, <0.05] in LLD patients with suicidal ideation, compared with the LLD patients without suicidal ideation [(104±49) min, (26±11)%]. Correlation analyses revealed that there was a significant correlation between the suicidal ideation and the percentage of stage N3 and sleep time of stage N3 (both <0.05).
Suicidal ideation is associated with less N3 sleep in LLD patients.
探讨老年抑郁症(LLD)患者睡眠参数与自杀观念之间的关系。
纳入2017年7月至2018年7月期间浙江大学医学院附属邵逸夫医院60岁以上的77例LLD患者。所有患者均接受汉密尔顿抑郁量表(HAMD)评估及整夜多导睡眠图(PSG)监测。采用HAMD第3项的自杀评分(HAM-D3)来界定是否存在自杀观念。随后,根据是否存在自杀观念症状(HAM-D3评分≥1,n = 46;HAM-D3评分为0,n = 31)将参与者分组。评估睡眠效率、总睡眠时间、睡眠开始后的觉醒时间、快速眼动百分比/潜伏期以及非快速眼动睡眠1-3期(N1-N3)。进行方差分析以探讨有自杀观念组和无自杀观念组之间睡眠参数与自杀观念的相关性。在模型1中,HAM-D3在单独的方差分析测试中作为自变量;在模型2中,将抑郁症状的影响作为睡眠参数的协变量进行评估。
有自杀观念的LLD患者的N3期睡眠时间少于无自杀观念的LLD患者[(55±41)分钟,P = -4.731,P < 0.05],N3期睡眠百分比也更低[(15±11)%,P = -4.194,P < 0.05],无自杀观念的LLD患者分别为[(104±49)分钟,(26±11)%]。相关性分析显示,自杀观念与N3期百分比及N3期睡眠时间均存在显著相关性(均P < 0.05)。
LLD患者的自杀观念与N3期睡眠减少有关。