Ambulatory sleep-wake patterns and variability in young people with emerging mental disorders
Ambulatory sleep-wake patterns and variability in young people with emerging mental disorders
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DOI：
10.1503/jpn.130247
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发表时间：
2015-01-01
影响因子：
4.3
通讯作者：
Hickie, Ian B.
中科院分区：
文献类型：
--
作者：
Robillard, Rebecca;Hermens, Daniel F.;Hickie, Ian B.
背景：精神障碍患者睡眠-觉醒异常的性质尚不清楚。本研究的目的是探讨在客观的动态措施的睡眠-觉醒和活动周期的青年人之间的焦虑，情绪或精神疾病的差异。方法：参与者接受了几天的腕动计监测。我们根据初步诊断将参与者分为5组（对照组、焦虑症组、单相抑郁症组、双相障碍组、精神病性障碍组）。结果如下：我们的研究招募了342名年龄在12-35岁之间的参与者：41名健康对照者、56名焦虑症患者、135名单相抑郁症患者、80名双相情感障碍患者和30名精神病患者。与对照组相比，焦虑、抑郁和双相情感障碍组的睡眠开始时间较晚;所有初步诊断组的睡眠偏移时间较晚;焦虑、双相情感障碍和精神病组的睡眠时间较长;精神病组的总睡眠时间较长;抑郁组的睡眠效率较低，焦虑和双相情感障碍组的趋势相似。患者亚组的睡眠参数比对照组的差异更大。余弦分析显示焦虑和双相组的昼夜活动曲线延迟，精神病组的昼夜曲线异常。局限性：虽然统计分析控制了年龄，但样本包括从青春期前到成年的个体。来自主要诊断亚组的大多数参与者正在服用精神药物，并且很大一部分患有其他共病精神障碍。结论：我们的研究结果表明，延迟和混乱的睡眠偏移时间是常见的各种精神障碍的年轻患者。然而，其他睡眠-觉醒周期紊乱似乎在广泛的诊断类别中更为突出。
Background: The nature of sleep-wake abnormalities in individuals with mental disorders remains unclear. The present study aimed to examine the differences in objective ambulatory measures of the sleep-wake and activity cycles across young people with anxiety, mood or psychotic disorders. Methods: Participants underwent several days of actigraphy monitoring. We divided participants into 5 groups ( control, anxiety disorder, unipolar depression, bipolar disorder, psychotic disorder) according to primary diagnosis. Results: We enrolled 342 participants aged 12-35 years in our study: 41 healthy controls, 56 with anxiety disorder, 135 with unipolar depression, 80 with bipolar disorder and 30 with psychotic disorders. Compared with the control group, sleep onset tended to occur later in the anxiety, depression and bipolar groups; sleep offset occurred later in all primary diagnosis groups; the sleep period was longer in the anxiety, bipolar and psychosis groups; total sleep time was longer in the psychosis group; and sleep efficiency was lower in the depression group, with a similar tendency for the anxiety and bipolar groups. Sleep parameters were significantly more variable in patient subgroups than in controls. Cosinor analysis revealed delayed circadian activity profiles in the anxiety and bipolar groups and abnormal circadian curve in the psychosis group. Limitations: Although statistical analyses controlled for age, the sample included individuals from preadolescence to adulthood. Most participants from the primary diagnosis subgroups were taking psychotropic medications, and a large proportion had other comorbid mental disorders. Conclusion: Our findings suggest that delayed and disorganized sleep offset times are common in young patients with various mental disorders. However, other sleep-wake cycle disturbances appear to be more prominent in broad diagnostic categories.