Kupfer D J, Ulrich R F, Coble P A, Jarrett D B, Grochocinski V, Doman J, Matthews G, Borbély A A
Psychiatry Res. 1984 Dec;13(4):335-43. doi: 10.1016/0165-1781(84)90081-7.
Abnormalities in a two-process model of sleep regulation (a sleep-dependent process, termed Process S, and a sleep-independent circadian process, termed Process C) have been proposed to account for sleep abnormalities in depressive states. The major tenets of the two-process model of sleep regulation as applied to depression are: the level of process S, as reflected by the electroencephalographic (EEG) slow-wave activity, corresponds to the sleep-dependent facet of sleep propensity; the pathognomonic changes of sleep in depressives are a consequence of a deficiency in the build-up of process S. The application of automated rapid eye movement (REM) and delta wave analyses in normal subjects and younger depressed patients supports the model to some extent: The time spent asleep is positively correlated with total delta waves (normals and depressives) and average delta waves (depressives); delta sleep is lower in depressives than in normals; the average delta wave count is significantly reduced in younger depressives over the total night and in non-REM period 1. The model also postulates that measures of phasic REM activity are inversely related to process S, suggesting that process S can be regarded as exerting an inhibitory influence on phasic REM activity.
睡眠调节的双过程模型（一个依赖睡眠的过程，称为过程S，以及一个独立于睡眠的昼夜节律过程，称为过程C）中的异常现象已被提出用于解释抑郁状态下的睡眠异常。应用于抑郁症的睡眠调节双过程模型的主要原则是：脑电图（EEG）慢波活动所反映的过程S的水平，对应于睡眠倾向中依赖睡眠的方面；抑郁症患者睡眠的特征性变化是过程S积累不足的结果。在正常受试者和年轻抑郁症患者中应用自动快速眼动（REM）和δ波分析在一定程度上支持了该模型：睡眠时间与总δ波（正常人和抑郁症患者）以及平均δ波（抑郁症患者）呈正相关；抑郁症患者的δ睡眠低于正常人；年轻抑郁症患者在整个夜间和非快速眼动期1的平均δ波计数显著减少。该模型还假设，相位性快速眼动活动的测量值与过程S呈负相关，这表明过程S可被视为对相位性快速眼动活动施加抑制性影响。
