Zhang Qingyu, Tong Maoqing, Ji Yunxin, Hou Yanbin, Lou Zongze, Wu Danjuan, Mi Yuwei, Miu Pingping, Tian Jiaxin, Zhu Zhenzhen, Ruan Liemin
Department of Psychosomatic Medicine, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
School of Medicine, Ningbo University, Ningbo, Zhejiang, China.
Front Psychiatry. 2024 Oct 14;15:1432538. doi: 10.3389/fpsyt.2024.1432538. eCollection 2024.
Little was known about the relationship between sleep disturbances and depressive and anxiety disorders, as well as the efficacy of treatment regimens.
During 2021 to 2023, a total of 417 participants were screened by Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Rating Scale (HAMA-14) for psychological status, and Pittsburgh sleep quality index (PSQI) assessment. 409 participants were finally enrolled, of which 188 (45.97%) were suffered from sleep disorders. All participants were received polysomnography (PSG) followed by six-week pharmacological treatment of escitalopram and zopiclone, and finally assessed by HAMD-17 and HAMA-14 for treatment efficacy.
PSG monitoring indicated that participants with depression experienced prolonged rapid eye movement sleep latency (REMSL) and increased wakefulness after sleep onset (WASO) (P=0.030 and P=0.002, respectively). Those with anxiety disorders demonstrated a significantly higher percentage of non-rapid eye movement sleep (NREM%) and reduced WASO (P=0.013 and P=0.001, respectively). After six-weeks pharmacological treatment, participants with or without sleep disorders exhibited with similar efficacy outcomes of depression and anxiety disorders (P>0.05). However, every point of PSQI increment at baseline would decrease 0.78 and 0.85 times of probability of effective pharmacological treatment of depression and anxiety disorders. Moreover, participants with both effective outcomes of depression and anxiety disorders were found significant shorter sleep onset latency (SOL) (P<0.001).
The insights gained underscore the necessity of considering sleep disturbances in enhancing the overall effectiveness of pharmacological treatments for depression and anxiety disorders.
睡眠障碍与抑郁和焦虑症之间的关系以及治疗方案的疗效鲜为人知。
在2021年至2023年期间，共有417名参与者通过汉密尔顿抑郁量表（HAMD - 17）和汉密尔顿焦虑量表（HAMA - 14）进行心理状态筛查，并进行匹兹堡睡眠质量指数（PSQI）评估。最终纳入409名参与者，其中188名（45.97%）患有睡眠障碍。所有参与者均接受多导睡眠图（PSG）检查，随后接受为期六周的艾司西酞普兰和佐匹克隆药物治疗，最后通过HAMD - 17和HAMA - 14评估治疗效果。
PSG监测表明，抑郁症患者的快速眼动睡眠潜伏期（REMSL）延长，睡眠起始后觉醒时间（WASO）增加（分别为P = 0.030和P = 0.002）。焦虑症患者的非快速眼动睡眠百分比（NREM%）显著更高，WASO减少（分别为P = 0.013和P = 0.001）。经过六周的药物治疗，有或没有睡眠障碍的参与者在抑郁和焦虑症的疗效结果上相似（P>0.05）。然而，基线时PSQI每增加一分，抑郁和焦虑症有效药物治疗的概率将分别降低0.78倍和0.85倍。此外，抑郁和焦虑症治疗均有效的参与者的睡眠起始潜伏期（SOL）明显更短（P<0.001）。
所获得的见解强调了在提高抑郁症和焦虑症药物治疗的整体有效性时考虑睡眠障碍的必要性。
