抑郁症自杀倾向与多导睡眠图的关系  

The Relationship Between Suicidal Tendency and Polysomnogram in Depressed Individuals

作　　者：邓先华[1] 孙学礼[1] 张波[1] 舒放[1] 唐娴[1] 

机构地区：[1]四川大学华西医院心理卫生中心,四川成都610041

出　　处：《华西医学》2007年第1期25-27,共3页West China Medical Journal

基　　金：国家十五攻关课题资助(2004DA7210A21)

摘　　要：目的探讨抑郁症患者自杀倾向与多导睡眠图之间的关系。方法对16例有明显自杀观念或自杀行为的抑郁症患者(自杀组)、20例无自杀观念或自杀行为的抑郁症患者(非自杀组)、20例正常对照者检测多导睡眠图,并进行睡眠参数比较。结果①抑郁症自杀组与非自杀组均存在诸多睡眠指标的异常,包括睡眠总时间减少、慢波睡眠百分比降低、睡眠效率和睡眠维持率降低、觉醒时间和觉醒次数增加、觉睡比和睡眠阶段S1百分比增加、REM睡眠潜伏期缩短以及REM密度增加。②自杀组与非自杀组相比,前者在睡眠进程方面表现为更加频繁的觉醒、更长的觉醒时间、更高的觉睡比以及更低的睡眠维持率,在REM睡眠方面,前者表现为更加严重的REM睡眠脱抑制,如REM睡眠潜伏期更短、整夜REM睡眠时间更长,整夜及第一个REM睡眠百分比更高、REM活动度和强度更高。结论抑郁症的睡眠维持障碍和REM睡眠紊乱与其自杀倾向可能具有密切联系,表现为频繁的觉醒、REM睡眠潜伏期缩短、REM活动度和强度增加以及REM睡眠时间延长的抑郁症患者可能预示更高的自杀风险。Objective： To study the relationship between suicidal tendency and polysomoogaphic parameters in depressed in-dividuals. Method： polysomnographic data were recorded in 16 depressed subjects with obvious suicidal ideation or behavior, 20 depressive patients without suicidal ideation or behavior and 20 normal controls, then their polysomnographic parameters were compared. Results： （1）Both suicide attempters and coonattempters showed many abnOrmal polysomnographic parameters, including reduced total sleep time, decreased percentage of slow wave sleep, decreased sleep efficiency and maintenance rate, and increased awakening time and number of awakening, increased awakening - asleeping Ratio and percentage of Stage 1 sleep, as well as shortened REM sleep latency and increased REM density. （2）In the aspects of sleep continuity, suicide attempters, compared to nonattempters, showed significantly more frequent awakenings, longer awakening time, higher awakening - asleeping ratio and lower Sleep maintenance rate. In the aspects of REM Sleep, suicide attempters showed more serious disinhibition of REM sleep, including significantly shorter REM sleep latency; longer REM Sleep duration, higher percentage of REM sleep both in the whole night data and in the fhst sleep period, and higher REM activity and intensity. Conclusion： In depressed individuals, It is probable that both impaired sleep maintenance and abnormal REM Sleep were closely related to their suicidal tendency, and those depressed subjects having frequent awakenings, shortened REM sleep latency, increased REM activity and intensity, increased REM Sleep duration （percentage） probably indicated higher suicide risk.

关 键 词：抑郁症 自杀 多导睡眠描记术 睡眠 

分 类 号：R749.4[医药卫生—神经病学与精神病学]