10月1日，星期三（心理中心）--根据专家所说，全美国几乎有60%的老人有睡眠方面的问题，不管是轻微的转辗反侧还是完全的失眠。
尽管睡眠不好的人充其量也就是烦恼或者最坏情况下就是身体不健康，对于过去有遭受抑郁影响的老年个体来说，睡眠不好是完全陷入抑郁的第一个征兆。
即将在美国精神病学杂志研究出版和在线可以阅览的一项研究中，UCLA精神分析教授DR.Michael和他的同事们提出了三个假设：在有睡眠障碍历史的老年人群中患抑郁的风险比率更高；在那些之前有抑郁症状的老人中，睡眠困扰也预示着抑郁的复发；睡眠困扰可以扮演独立与其他抑郁症状致使抑郁复发的危险因素。
这个研究证实了这三个假设。
Irwin说“失眠在抑郁病人中是频率发生最多的睡眠困扰问题，且被看作当前抑郁的一种症状。”
“但是抑郁困扰在过去经历过抑郁症的特殊的健康人中开始出现时，我们发现这可能是再次发生抑郁的前奏。”
该研究评估了351名60岁及以上的成年人，这些数中，145人中有主要和非主要的已经痊愈了点抑郁症患者，而另外206个人没有抑郁历史和其他心理疾病。
在超过两年的时间内的四个不同时期下对被试的抑郁发作，抑郁症状，睡眠质量和慢性内科疾病进行评估。
研究者发现有抑郁历史的被试中23个复发，比较而言没有心理疾病的那组被试只有1人复发。在第一组中研究者能够根据个人的睡眠困扰来预测抑郁的复发。
Irwin指出这种联系建立在没和其他抑郁症状，慢性内科疾病或其他任何抗抑郁药掺和在一起的基础上。
Irwin说这个研究首次阐述了睡眠困扰在老年人中扮演了抑郁复发的独立的危险因素。
Irwin还说：“不幸的是，睡眠困难往往被认为是年龄老化的一部分，而且在医生常规检查里，对于老年人睡眠质量的询问和评估常常被忽视。”
“因为我们知道睡眠障碍同老年人身体功能的下降和死亡率的增加有关，所以省略这项特别的严重。”
“现在，这项研究显示睡眠困扰和晚年抑郁症有相关，进步带来了相当大的发病率和死亡率的危险。”
为了确定老年人抑郁的风险，Irwin使用了两步策略。第一步是评估个体是否有抑郁发作的病史，另外一步看他们目前是否正在经历睡眠困扰
“鉴于睡眠困扰是一种可改变的危险因素，”他说，“这些研究发现告诉我们需要制定指向睡眠困扰的治疗，以预防老年人抑郁症复发。”
According to experts, nearly 60 percent of the nation’s elderly have trouble sleeping, whether it’s a lot of tossing and turning or outright bouts of insomnia.
While for most people sleeplessness can be annoying at best or unhealthy at worst, for elderly individuals who have suffered from depression in the past, poor sleep may be the first sign that a new bout of depression is coming on.
In a study to be published in an upcoming issue of the American Journal of Psychiatry and currently available online, UCLA professor of psychiatry Dr. Michael Irwin and his colleagues posed three hypotheses: risk for depression would be higher among older people with a prior history of the disorder; among those with prior depression, sleep disturbance could predict a relapse or recurrence; and sleep disturbances could act as a risk factor for depression recurrence separate from other depressive symptoms.
The study confirmed all three hypotheses.
“Insomnia is the most frequent sleep disturbance in depressed patients and is viewed as a symptom of current depression,” said Irwin.
“But when sleep disturbances begin to emerge in an otherwise healthy adult who has experienced depression in the past, we found that it may serve as a precursor to another attack of depression.”
The study looked at 351 adults, age 60 and older. Of that number, 145 had a prior history of major or non-major depression that was in full remission, while 206 had no prior history of depression or other mental illness.
The participants were assessed at four different times over a two-year period for depressive episodes, depressive symptoms, sleep quality and chronic medical disease.
The researchers found that of the subjects with prior depression, 23 had a relapse, compared with only one person in the group without prior mental illness. With the first group, researchers were able to predict depression recurrence based on individuals’ sleep disturbance.
Irwin noted that this association was established independently of other depressive symptoms, chronic medical disease or any use of antidepressants.
The study, Irwin said, is the first to demonstrate that sleep disturbances act as an independent risk factor for depression recurrence in older adults.
“Unfortunately, sleep difficulties are often considered to be a part of normal aging, and asking about and assessing the quality of an older person’s sleep is frequently overlooked during routine doctor visits,” Irwin said.
“The omission is particularly striking, since we know that sleep disturbance is associated with declines in health functioning and with increases in all causes of mortality in older adults.
“And now, this study shows that sleep disturbance is often related to depressive disorders in late life, which carry further considerable risks for morbidity and mortality.”
To identify older adults at risk for depression, Irwin said, a two-step strategy can be employed. One step involves assessment of whether individuals have had a prior episode of depression, the other whether they have current and ongoing sleep disturbance.
“Given that sleep disturbance is a modifiable risk factor,” he said, “these findings tell us that we need to develop treatments that target sleep disturbances for the prevention of depression recurrence in older adults.”
