Use of selective serotonin reuptake inhibitors and sleep disturbances in community-dwelling older women
Use of selective serotonin reuptake inhibitors and sleep disturbances in community-dwelling older women
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DOI：
10.1111/j.1532-5415.2006.00880.x
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发表时间：
2006-10-01
影响因子：
6.3
通讯作者：
Stone, Katie L.
中科院分区：
文献类型：
--
作者：
Ensrud, Kristine E.;Blackwell, Terri L.;Stone, Katie L.
目的：确定社区老年妇女（包括无抑郁症证据的妇女）使用选择性5-羟色胺再摄取抑制剂（SSRIs）与睡眠障碍客观指标之间的关系。2853名71岁及以上的妇女（2，630名非抗抑郁药使用者和223名单独服用SSRIs，不与其他抗抑郁药联合使用）。药物使用，使用访谈者管理的问卷进行评估，并验证药物容器和用于分类药物类型的计算机化词典的使用情况;抑郁症的证据使用自我报告或老年抑郁量表评分为6分或更高进行评估;睡眠参数使用腕关节活动记录仪进行测量，数据收集平均连续4个24小时。在2，853名女性和2，337名没有抑郁症证据的女性中，服用SSRIs的女性睡眠障碍比未服用抗抑郁药的女性更常见。在排除有抑郁症证据的女性并调整多种潜在混杂因素后，服用SSRIs的女性更有可能睡眠时间为5小时或更短（多变量比值比（莫尔）= 2.15，95%置信区间（CI）= 1.044.47），睡眠效率低于70%（莫尔比= 2.37，95% CI = 1.32-4.25），睡眠潜伏期≥ 1小时（莫尔比= 3.99，95% CI = 2.29-6.96）和8次或更长时间觉醒发作（莫尔比= 1.75，95%CI = 0.99-3.10）。结论：老年妇女使用SSRI，包括那些没有抑郁症证据的妇女，与睡眠障碍的可能性更大有关，包括睡眠效率更差，更长的睡眠潜伏期和睡眠片段，表现为多次长时间觉醒。这些结果增加了SSRI在老年人群中使用的风险和益处的不确定性。
OBJECTIVES: To determine the association between use of selective serotonin reuptake inhibitors (SSRIs) and objective measures of sleep disturbances in older community-dwelling women, including women without evidence of depression.DESIGN: Cross-sectional study.SETTING: Four U.S. clinical centers.PARTICIPANTS: Two thousand eight hundred fifty-three women aged 71 and older (2,630 nonusers of antidepressants and 223 taking SSRIs alone, not in combination with other antidepressants).MEASUREMENTS: Medication use, assessed using an interviewer-administered questionnaire with verification of use from medication containers and computerized dictionary used to categorize type of medication; evidence of depression assessed using self-report or a score of 6 or higher on the Geriatric Depression Scale; and sleep parameters measured using a wrist actigraph, with data collected for an average of four consecutive 24-hour periods.RESULTS: Of the overall cohort of 2,853 women and of 2,337 women without evidence of depression, sleep disturbances were more common in women taking SSRIs than in those not taking antidepressants. After excluding women with evidence of depression and adjusting for multiple potential confounders, women taking SSRIs were more likely to have a sleep duration of 5 hours or less (multivariate odds ratio (MOR) = 2.15, 95% confidence interval (CI) = 1.044.47), sleep efficiency less than 70% (MOR = 2.37, 95% CI = 1.32-4.25), sleep latency of 1 hour or more (MOR = 3.99, 95% CI = 2.29-6.96) and eight or more long wake episodes (MOR = 1.75, 95% CI = 0.99-3.10).CONCLUSION: SSRI use by older women, including those without evidence of depression, is associated with a greater likelihood of sleep disturbances, including poorer sleep efficiency, longer sleep latency, and sleep fragmentation, manifested by multiple long wake episodes. These results add to the uncertainty regarding risks and benefits of SSRI use in aged populations.