Buysse D J, Hall M, Tu X M, Land S, Houck P R, Cherry C R, Kupfer D J, Frank E
Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA.
Psychiatry Res. 1998 Jun 15;79(2):105-22. doi: 10.1016/s0165-1781(98)00028-6.
In this study, we aimed to determine the latent structure of multiple EEG sleep variables in patients with major depressive disorder (MDD) and in healthy control subjects and to examine associations between sleep factors and clinical variables. Subjects included 109 women with MDD and 54 healthy control women. EEG sleep data were collected prior to any treatment. Principal components analysis (PCA) was conducted on a set of 24 sleep variables. Separate PCAs were run for patients with MDD, control subjects, and a matched group of patients and controls. Other analyses included correlations, t-tests and MANOVA. Each PCA identified four sleep factors that explained 70% of the total variance in individual sleep variables: slow wave sleep, REM sleep, sleep continuity and REM latency/delta sleep ratio (RL/DSR). Patients with MDD and healthy controls differed on the mean value of the sleep continuity factor, and a multivariate analysis of variance based on the PCA identified MDD-control differences in REM sleep and sleep continuity. In the MDD group, slow wave sleep correlated inversely with age and personality disorder symptoms; sleep continuity correlated with subjective sleep quality and anxiety; and RL/DSR correlated inversely with age. The mean value of the REM factor was higher among treatment non-responders than responders. EEG sleep variables have a similar latent structure in women with MDD and in healthy controls. These sleep factors are supported conceptually and empirically, and correlate with clinical measures in women with MDD. Multivariate statistical techniques decrease the risk of Type I and Type II errors when using a large number of collinear sleep measures, and can clarify conceptual issues related to sleep and depression.
在本研究中，我们旨在确定重度抑郁症（MDD）患者和健康对照者中多个脑电图睡眠变量的潜在结构，并研究睡眠因素与临床变量之间的关联。受试者包括109名患有MDD的女性和54名健康对照女性。在任何治疗之前收集脑电图睡眠数据。对一组24个睡眠变量进行主成分分析（PCA）。分别对患有MDD的患者、对照者以及一组匹配的患者和对照者进行PCA。其他分析包括相关性分析、t检验和多变量方差分析。每次PCA均确定了四个睡眠因素，这些因素解释了个体睡眠变量中70%的总方差：慢波睡眠、快速眼动睡眠、睡眠连续性以及快速眼动潜伏期/δ睡眠比率（RL/DSR）。患有MDD的患者和健康对照者在睡眠连续性因素的平均值上存在差异，基于PCA的多变量方差分析确定了MDD患者与对照者在快速眼动睡眠和睡眠连续性方面的差异。在MDD组中，慢波睡眠与年龄和人格障碍症状呈负相关；睡眠连续性与主观睡眠质量和焦虑相关；RL/DSR与年龄呈负相关。治疗无反应者的快速眼动因素平均值高于有反应者。MDD女性和健康对照女性的脑电图睡眠变量具有相似的潜在结构。这些睡眠因素在概念和实证上均得到支持，并且与MDD女性的临床指标相关。当使用大量共线性睡眠测量指标时，多变量统计技术可降低I型和II型错误的风险，并能阐明与睡眠和抑郁症相关的概念性问题。
