上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (1): 51-.doi: 10.3969/j.issn.1674-8115.2020.01.008

• 论著·临床研究 • 上一篇    下一篇

睡眠呼吸暂停综合征延长双相障碍患者抑郁相的快速眼动睡眠时间并缩短躁狂相的熟睡时间

金志兴1*，王媺媞1*，周 千1#，吕洞宾1，王 凡1，黄秦特1，吴政霖1，李海滨1，徐初琛1，曹 岚1，赵 杰2，曹彤丹2，黄海婧1，方贻儒1，洪 武1#   

  1. 1. 上海交通大学医学院附属精神卫生中心精神科，上海200030；2. 上海市黄浦区精神卫生中心精神科，上海200023
  • 出版日期:2020-01-28 发布日期:2020-03-05
  • 通讯作者: 周 千，电子信箱：qianzhoucmu@163.com。洪 武，电子信箱：drhongwu@126.com。#为共同通信作者。
  • 作者简介:金志兴（1967—），男，主治医师，学士；电子信箱：jzx1130@163.com。王媺媞（1991—），女，住院医师，硕士；电子信箱：15216651601@163.com。*为共同第一作者。
  • 基金资助:
    国家重点研发计划（2016YFC0906300）；国家自然科学基金（81701344）；上海市卫生和计划生育委员会科研课题（201740115）。

Sleep apnea hypopnea syndrome prolongs rapid eyes movement sleep time in depressive state and shortens deep sleep time in manic state in patients with bipolar disorder

JIN Zhi-xing, WANG Mei-ti, ZHOU Qian, Lü Dong-bin, WANG Fan, HUANG Qin-te, WU Zheng-lin, LI Hai-bin, XU Chu-chen, CAO Lan, ZHAO Jie, CAO Tong-dan, HUANG Hai-jing, FANG Yi-ru, HONG Wu   

  1. 1. Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Department of Psychiatry, Shanghai Huangpu District Center for Mental Health, Shanghai 200023, China
  • Online:2020-01-28 Published:2020-03-05
  • Supported by:
    National Key R&D Program of China (2016YFC0906300); National Natural Science Foundation of China (81701344); Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning (201740115).

摘要： 目的·观察睡眠呼吸暂停综合征（sleep apnea hypopnea syndrome，SAS）对双相障碍（bipolar disorder, BD）患者不同发作状态下睡眠分期的影响。方法·收集210例18～65岁的健康对照及年龄相当的235例BD患者，根据BD患者的发作状态将其分为抑郁相、躁狂相和混合相。运用基于心肺耦合分析的睡眠质量评估系统，采集受试者的睡眠时间结构、睡眠体位、睡眠心率等指标；根据睡眠呼吸紊乱指数（apnea-hypopnea index，AHI）是否≥5次/h确定每组对象是否患有SAS，并针对BD的发作状态和是否患有SAS进行两因素多元方差分析。结果·SAS对抑郁相BD患者的快速眼动（rapid eyes movement, REM）睡眠时间有显著延长作用（P=0.000），对躁狂相BD患者的熟睡时间有显著缩短作用（P=0.011）。另外，躁狂相BD患者的睡眠期间（熟睡、浅睡及REM睡眠期）心率增快在3种发作状态中最为显著（P=0.000），仰卧位对躁狂相BD患者的SAS症状加重的影响在3种发作状态中最为显著（P=0.002）。结论·SAS对BD患者不同发作状态下的睡眠分期可产生不同的影响。

关键词: 双相障碍, 躁狂相, 抑郁相, 混合相, 睡眠呼吸暂停综合征

Abstract:

Objective · To observe the effect of sleep apnea hypopnea syndrome (SAS) on sleep staging of bipolar disorder patients in different states. Methods · A total of 210 healthy controls aged 18–65 and 235 bipolar disorder patients of the same age were collected. The bipolar disorder patients were divided into depressive, manic and mixed states. Sleep time structure, sleep posture, heart rate and other indicators were collected by using sleep quality assessment system based on cardiopulmonary coupling analysis. According to whether the apnea-hypopnea index (AHI) was ≥ 5 times/h, whether they had SAS were determined. Two-way multivariate analysis of variance was conducted, investigating the effect of clinical states and SAS, on several sleep indicators. Results · SAS significantly prolonged rapid eyes movement (REM) sleep time of patients in depressive state (P=0.000) and shortened deep sleep time of patients in manic state (P=0.011). In addition, the heart rate during sleep (including deep sleep, light sleep and REM sleep) of patients in manic state increased most significantly among the three clinical states (P=0.000). Lying supine aggravated SAS most significantly in manic state among the three clinical states (P=0.002). Conclusion · SAS has different effects on the sleep staging of bipolar disorder patients in different states.

Key words: bipolar disorder, manic state, depressive state, mixed state, sleep apnea hypopnea syndrome