年轻慢性失眠患者睡眠期间的心率及心率变异性对照研究  

Comparative Study of Heart Rate and Heart Rate Variability During Sleep in Young Adults with Chronic Insomnia

作　　者：朱虹 邹学良 钟志军 刘桥生 ZHU Hong;ZOU Xue-liang;ZHONG Zhi-jun;LIU Qiao-sheng(Jiangxi Mental Hospital,Nanchang 330029,China;Jiangxi Provincial People's Hospital,Nanchang 330038,China)

机构地区：[1]江西省精神病院,南昌330029 [2]江西省人民医院,南昌330038

出　　处：《中国临床心理学杂志》2024年第5期1155-1159,共5页Chinese Journal of Clinical Psychology

基　　金：江西省自然科学基金“有氧运动训练对抑郁症及其睡眠的影响的机制研究”(批准号:S2017ZRMSB2145)的支持。

摘　　要：目的:分析年轻慢性失眠患者睡眠期间的心率及心率变异性变化,探讨慢性失眠对心血管功能变化的影响机制。方法:选取江西省精神病院心理科和江西省人民医院神经内科2020年7月至2023年10月的17例年龄为18~35岁的慢性失眠患者和17例睡眠结构大致正常的正常对照者。通过对慢性失眠患者和正常对照者进行两晚的多导睡眠监测来分析睡眠期间的心率和心率变异性(heart rate variability, HRV)变化。结果:在非快速眼动睡眠1和2(non-rapid eye movement sleep stage 1 and 2, N1 and N2)及快速动眼睡眠(rapid eye movement, REM)期,慢性失眠组比正常对照组具有显著更高的心率、更低的RR间期标准差(RR interval standard deviation, SDNN)、更低的心率变异性高频成分(heart rate variability high frequency, HRV HF)功率以及更高的低频功率与高频功率的比率(low frequency power/high frequency power, LF/HF ratio)。慢性失眠组比正常对照组具有更高的N1、N2和REM期的微觉醒指数。结论:在N1、N2和REM睡眠期,慢性失眠组均比正常对照组具有更高的心率、更低的SDNN、更低的HRV HF功率以及更高的LF/HF ratio。这可能与慢性失眠患者睡眠期间频繁微觉醒有关。Objective: To analyze changes in heart rate and heart rate variability during sleep in young patients with chronic insomnia, and to explore the mechanism by which chronic insomnia affects changes in cardiovascular function.Methods: Select 17 chronic insomnia patients aged 18~35 years old and 17 controls aged 18~35 years old with generally normal sleep structures from the department of psychology of Jiangxi provincial psychiatric hospital and department of neurology of Jiangxi provincial people's hospital from July 2020 to October 2023. Heart rate and heart rate variability(HRV)changes during sleep were analyzed by two-night polysomnography in insomnia patients and normal controls. Results: In the non-rapid eye movement(REM) sleep stage 1(N1), N2, and REM sleep stages, chronic insomnia patients had higher heart rates, lower RR interval standard deviation(SDNN), lower heart rate variability high frequency power and higher low frequency power/high frequency power(LF/HF ratio) than those in the normal controls. The chronic insomnia patients had higher microarousal indexes in N1, N2, and REM sleep stages than those in the normal controls. Conclusion: In N1, N2and REM sleep stages, chronic insomnia patients had higher heart rate, lower SDNN, lower HRV HF power and higher LF/HF ratio than those in the normal controls. There may be related to frequent microarousal during sleep in patients with chronic insomnia.

关 键 词：慢性失眠 年轻患者 心率 心率变异性 微觉醒 

分 类 号：R395.1[哲学宗教—心理学]