Comparison On Objective And Subjective Sleep Features Between Primary Insomnia And Depression Patients

Objective: Insomnia and depression are common mental diseases in the psychological outpatient department,Most depression patients have sleep disorders of different degrees,this article aims to explore the subjective and objective sleep features of primary insomnia and depression patients as well as study their personal sleep beliefs. Also, this article compares the sleep features of these two diseases.Methods: 69 patients with primary insomnia or depression in the department of psychology of Nanjing Brain Hospital from October 2013 to December 2014 were assessed by DBAS-16, Pittsburgh sleep quality index(PSQI), self-rating depression scale(SDS), self-rating anxiety scale(SAS),and all of them were monitored by the whole-night polysomnography(PSG)records for objective sleep quality.All objects were divided into the primary insomnia and depression groups according to the related criteria in the Dignostic and Statistical Manual formulated by the American Psychiatric Association,Eliminate organic mental disorder or mental active substances and non addictive substances caused by depression and other sleep disorders, such as sleep apnea or muscle cramps.Results: 1) There was a discrepancy between subjective(PSQI) and objective(PSG)sleep in primary insomnia patients. The subjective( PSQI) total Sleep time(198.95±78.73)min、sleep latency(79.08±61.17)min and sleep efficiency(45.14±23.17)% showed a significant lower than the objective indictors(PSG)(341.45±90.97)min、(46.95±45.00)min 与(60.44±15.74)%. 2) For patients with primary insomnia, sleep latency of PSQI was correlated negatively with the“consequences caused by insomnia”of DBAS(r=-0.327,p=0.045);The hypnotic drug of PSQI was correlated negatively with “the knowledge of drug”(r=-0.469,p=0.003) as well as the total score of DBAS(r=-0.325,p=0.046). The total Recorded Time of PSG was correlated positively with the “consequences caused by insomnia”(r=0.455,p=0.04)、“worries about sleep”(r=0.652,p=0.000)and the total score of DBAS(r=0.597,p=0.000).The total Sleep Time of PSG was correlated positively with the “consequences caused by insomnia”(r=0.337,p=0.039)、“worries about sleep”(r=0.332,p=0.042)、“the knowledge of drug”(r=0.333,p=0.041)and the total score of DBAS(r=0.427,p=0.008).REM Activity of PSG was correlated positively with “the knowledge of drug”(r=0.336,p=0.039)and negatively with“Expectations of sleep”(r=-0.374,p=0.021).REM Density of PSG was correlated negatively with “worries about sleep”(r=-0.346,p=0.033).slow wave sleep of PSG was correlated negatively with “worries about sleep”(r=-0.349,p=-0.032). 3) There was a discrepancy between subjective(PSQI) and objective(PSG) sleep in primary insomnia patients. The subjective total Sleep time(187.74±99.79)min、sleep latency(129.03±80.51)min and sleep efficiency(38.58±19.90)% showed a significant lower than the objective indictors( 330.97±132.78) min 、(52.45±54.06)%与(56.95±18.21)min. 4) For patients with depression,“the knowledge of drug” of DBAS was correlated negatively with the sleep quality(r=-0.443,p=0.012)and the dayfunction(r=-0.412,p=0.021) of PSQI.The total score of DBAS was correlated negatively with the sleep quality of PSQI(r=-0.367,p=0.042).REM Density of PSG was correlated negatively with “the knowledge of drug(r=-0.385,p=0.033) 5) There was a discrepancy between patients with primary insomnia and patients with depression in the “worried about sleep” of DBAS,the primary 6) insomnia(13.55±4.88)showed a significant higher than the depression(11.45±2.80). 7) For the subjective sleep quality by PSQI,the primary insomnia total score(16.34±3.11)、sleep latency(2.50±0.89)and daily function(2.42±0.79) showed a significant lower than the depression(17.74±2.16)、(2.84±0.37)and(2.77±0.49). 8) For the objective sleep quality by PSG,the primary insomnia REM Intensity(6.11±3.12)and REM Density(36.39±15.87) showed a significant lower than the depression(8.32±4.65)、(50.35±6.57).Conclusions: 1) both Primary insomnia and depression,their subjective sleep quality(PSQI) all showed a significant lower than objective sleep quality(PSG). 2) There existed different correlativity in both the depressive patients and insomniacs with sleep quality(PSQI and PSG) and personal sleep beliefs(DBAS). 3) Compared primary insomnia and depression,There was a discrepancy on personal sleep beliefs(DBAS)、subjective sleep quality(PSQI) and objective sleep quality(PSG). Patients with depression are more worried about sleep quality,and the daily function of depression showed a significant lower than the primary insomnia.the period of REM in depression are more actively.