客观测量患有和未患有抑郁症的成年人和老年人的睡眠状况：系统回顾与荟萃分析。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-10-10 DOI:10.1016/j.sleep.2024.10.011

Andrea Ricciardiello , Jun Z. Teh , Aaron K.F. Lam , Nathaniel S. Marshall , Sharon L. Naismith , Angela L. D'Rozario

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引用次数: 0

摘要

抑郁症患者，尤其是老年人的睡眠结构尚不明确。我们研究了患有和未患有抑郁症的成年人和老年人（50 岁以上）在睡眠宏观和微观结构方面的差异。我们通过 PubMed、Scopus、Web of Science 和 Embase 数据库进行了系统性回顾，共发现了 2135 篇论文。两名审稿人根据 PRISMA 指南排除了相关文章。有 15 篇文章符合纳入标准。进行了随机效应模型荟萃分析。采用 NICE 病例对照指南评估偏倚风险。在这 15 篇文章中，共有 838 名参与者接受了客观睡眠测量（406 名抑郁症患者和 432 名对照组患者）。与对照组相比，所有成人抑郁症患者的总睡眠时间更短、睡眠开始潜伏期更晚、睡眠开始后唤醒率更高、眼球快速运动潜伏期（ROL）更短、眼球快速运动 REM 密度更高。其中两项研究对 62 名老年人（31 名抑郁症患者，31 名对照组患者）的睡眠结构进行了检测。与老年对照组相比，患有抑郁症的老年人第一阶段睡眠较多，第二阶段睡眠较少，快速眼动潜伏期（ROL）较短，但在睡眠效率、快速眼动睡眠或快速眼动密度方面没有组间差异。有六项研究的病例对照选择不当，去除这些因素后，所有成年人的快速动眼期密度和快速动眼期潜伏期的影响均无效。由于现有研究有限，因此无法对睡眠微结构测量进行荟萃分析。与对照组相比，患有抑郁症的成年人的睡眠开始时间和睡眠持续时间都略差。在抑郁症成人中观察到快速眼动睡眠的改变，但这些影响并不显著。与相对对照组相比，患有抑郁症的年轻人和老年人的睡眠宏观结构差异并不一致。

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Objective measures of sleep in adults and older adults with and without depression: A systematic review and meta-analysis

Sleep architecture is poorly defined in people with depression, especially in older adults. We investigated differences in sleep macro- and micro-architecture between adults and older adults (>50 years) with and without depression.

A systematic review identified 2135 papers through PubMed, Scopus, Web of Science and Embase databases. Two reviewers excluded articles using PRISMA guidelines. Fifteen articles met inclusion criteria. A random effects model meta-analysis was performed. NICE case-control guidelines were used to assess risk of bias.

In the fifteen articles, 838 participants underwent objective sleep measurement (406 depression and 432 control). All adults with depression had less total sleep time, delayed sleep onset latency, higher wake after sleep onset, shorter rapid eye movement latency (ROL) and greater rapid eye movement REM density than controls. Two of these studies examined sleep architecture in 62 older adults (31 depression, 31 control). Older adults with depression had more stage 1 sleep, less stage 2 sleep, shorter ROL than older controls with no between-group difference in sleep efficiency, REM sleep or REM density. Six studies had poor case-control selection, which when removed nullified the effects of REM density and REM latency in all adults. Sleep micro-architecture measures could not be meta-analysed due to the limited studies available.

Adults with depression had moderately worse sleep initiation and continuity than controls. Alterations to REM sleep were observed in adults with depression, however these effects were not robust. Sleep macro-architecture differences were not consistent in younger adults and older adults with depression, compared to relative controls.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.