The correlation between the degree of depression and polysomnography parameters and fatigue level in patients with late-onset depression
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摘要:
目的 比较晚发性抑郁症患者与非抑郁症老年患者多导睡眠参数及疲劳水平差异，并进一步对晚发性抑郁症患者抑郁程度与睡眠质量、结构以及疲劳水平的相关性进行评估。 方法 以绍兴市第七人民医院2020年3月—2023年3月间收治的晚发性抑郁症患者52例作为研究组，并选取同期非抑郁症老年患者67例作为对照组。比较组间多导睡眠参数水平以及疲劳水平。评估晚发性抑郁症患者抑郁程度与多导睡眠参数及疲劳水平的相关性。 结果 研究组患者睡眠效率(SE)、N2期百分比(N2%)、慢波睡眠期百分比(SWS%)低于对照组(P＜0.05)；研究组匹茨堡睡眠质量指数(PSQI)、睡眠潜伏期(SL)、微觉醒指数(MAI)、疲劳严重程度量表(FSS)评分、N1期百分比(N1%)、眼球快速运动睡眠百分比(REM%)、眼球快速运动睡眠(REM)活动度、强度以及密度高于对照组(P＜0.05)。相关性分析显示，SE、N2%与患者抑郁程度呈负相关关系，rs分别为-0.869和-0.734；其他指标均与患者抑郁程度呈正相关关系，分别为PQSI评分(rs=0.786)、SL(rs=0.649)、MAI(rs=0.714)、FSS评分(rs=0.738)、N1%(rs=0.687)、SWS%(rs=0.608)、REM%(rs=0.708)、REM活动度(rs=0.815)、REM强度(rs=0.837)和REM密度(rs=0.707)。 结论 晚发性抑郁症患者睡眠质量下降，睡眠结构紊乱，疲劳感加重，且与患者抑郁程度呈线性相关关系。 Abstract:Objective The differences in polysomnography parameters and fatigue levels were compared between patients with late-onset depression and non-depressed elderly patients, and the correlation between the degree of depression and sleep quality, structure and fatigue level in patients with late-onset depression was further evaluated. Methods A total of 52 patients with late-onset depression admitted to Shaoxing Seventh People ' s Hospital from March 2020 to March 2023 were selected as the study group, and 67 elderly patients without depression during the same period were selected as the control group. The levels of polysomnography parameters and fatigue were compared between groups. Additionally, the correlation between the degree of depression and polysomnography parameters as well as fatigue level in patients with late-onset depression was evaluated. Results The sleep efficiency (SE), percentage of N2 phase (N2%) and percentage of slow wave sleep (SWS%) in the study group were lower than those in the control group (P < 0.05). The Pittsburgh sleep quality index (PSQI), sleep latency (SL), micro-arousal index (MAI), fatigue severity scale (FSS), percentage of N1 phase (N1%), percentage of rapid eye movement sleep (REM%), activity, intensity and density of rapid eye movement sleep (REM) in the study group were higher than those in the control group (P < 0.05). Correlation analysis showed that SE and N2% were negatively correlated with the degree of depression in patients, rs=-0.869 and -0.734, respectively. Other indicators were positively correlated with the degree of depression in patients, which were PQSI score (rs=0.786), SL (rs=0.649), AMI (rs=0.714), FSS score (rs=0.738), N1% (rs=0.687), SWS% (rs=0.608), REM% (rs=0.708), REM activity (rs=0.815), REM intensity (rs=0.837) and REM density (rs=0.707). Conclusion The sleep quality of patients with late-onset depression is decreased, accompanied by disrupted sleep structure and aggravated fatigue, exhibiting a linear correlation with the degree of depression. -
Key words:
- Late-onset depression /
- Polysomnography parameters /
- Degree of depression /
- Fatigue level
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表 1 2组患者一般资料比较
Table 1. Comparison of general data between the two groups of patients
组别 例数 性别[例(%)] 年龄[M(P25, P75)，岁] “三高”情况[例(%)] OSAHS[例(%)] 男性 女性 无 1种 2种 3种 是 否 研究组 52 17(32.69) 35(67.31) 64.50(62.25, 67.00) 4(7.69) 19(36.54) 18(34.62) 11(21.15) 10(19.23) 42(80.77) 对照组 67 32(47.76) 35(52.24) 64.00(62.00, 68.00) 11(16.42) 27(40.30) 19(28.36) 10(14.92) 11(16.42) 56(83.58) 统计量 2.745a -0.393b -1.591c 0.159a P值 0.098 0.695 0.112 0.690 注：a为χ2值，b为U值，c为Z值。 
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表 2 2组患者PSQI评分、多导睡眠监测相关睡眠质量指标以及FSS评分比较(x±s)
Table 2. Comparison of PSQI score, polysomnography-related sleep quality indicators and FSS score between the two groups of patients (x±s)
组别 例数 PSQI评分(分) TST(min) SL(min) SE(%) MAI(次/h) FSS评分(分) 研究组 52 10.88±3.01 390.96±36.35 38.33±6.39 64.53±5.71 21.88±5.64 40.33±5.43 对照组 67 9.42±3.28 403.27±39.79 34.46±5.75 68.03±4.77 17.81±4.92 33.33±5.43 t值 2.508 1.737 3.466 3.641 4.207 6.971 P值 0.014 0.085 0.001 ＜0.001 ＜0.001 ＜0.001
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表 3 2组患者多导睡眠监测相关睡眠结构指标比较(x±s)
Table 3. Comparison of sleep structure indexes related to polysomnography between the two groups of patients (x±s)
组别 例数 NREM REM N1% N2% SWS%a REM% REM活动度 REM强度 REM密度 研究组 52 51.59±3.48 32.21±4.14 6.71±0.49 10.24±0.72 27.14±6.15 6.16±0.71 58.28±4.99 对照组 67 43.16±5.14 41.24±5.06 5.96±0.47 8.89±0.63 25.04±4.63 5.67±0.81 54.01±8.84 t值 10.649 10.439 8.327 10.877 2.049 3.409 3.118 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 0.043 0.001 0.002 注：a表示SWS即N3+N4。
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表 4 研究组患者抑郁程度与睡眠质量、疲劳水平的相关性分析(n=52)
Table 4. Correlation analysis of depression degree with sleep quality and fatigue level in study group (n=52)
统计量 PQSI评分
(分)SL
(min)SE
(%)MAI
(次/h)FSS评分
(分)rs值 0.786 0.649 -0.734 0.714 0.738 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001
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表 5 研究组患者抑郁程度与睡眠结构的相关性分析(n=52)
Table 5. Correlation analysis of depression degree and sleep structure in study group (n=52)
统计量 N1% N2% SWS% REM% REM活动度 REM强度 REM密度 rs值 0.687 -0.869 0.608 0.708 0.815 0.837 0.707 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001
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