529531. Posted with permission ...

529531. Published with permission from Russian Medical Journal

Night sleep in depression

J. Levin, SI Staffs, IG Hanoun clinical picture of depression (D) is composed of affective, motor, autonomic and dissomnicheskih disorders, which introduces the problem of sleep disorders in terms of the most relevant in this disease. As used in this case, the term "dissomnicheskie" reflects the diversity of these disorders, including both insomnicheskie and gipersomnicheskie manifestations. According to various statistics, the participation of sleep disorders in a cycle of sleep - waking at A is 83 - 100%, which is apparently due to different methodological possibilities of evaluation, since the objective polysomnographic studies - it is always 100%. Such obligate cycle disorders sleep - waking at D is based on common neurochemical processes. Serotonin, breach of mediation which play a crucial role in the genesis of the D, not only has outstanding significance in the organization of d-sleep, but also in the initiation of REM sleep (FBS). This also applies to other biogenic amines, particularly norepinephrine and dopamine deficit which has a value in the development of D, and especially The sleep-wake cycle. Sleep disorders can be as basic (and sometimes the only) complaint, disguising D, and one of many. This is particularly evident in the example of the so-called hidden (masked) D, because this form of pathology of sleep disorders may be leading, and sometimes the only manifestation of the disease. It is believed that the "torn sleep or early morning awakening, along with a decrease in awakenings and a decrease in capacity for emotional resonance can serve as an indication of the presence of D in the absence of a dreary mood. So far there is no conclusion of the presentation of the salient features of sleep disorders in various forms of D, though it has long been noted for their great phenomenological diversity. Changes in sleep are characterized by reduction of endogenous D d-sleep, a shortening of the latent period of FBS, increasing density of rapid eye movement (REM - one of the major phenomena that characterize the FBS), frequent awakenings. When psychogenic D in the structure of insomnia with sleep disorders dominated by compensatory lengthening of sleep in the morning, while in endogenous depression often recording part of the night and early final awakening. Marked decrease in the depth of sleep and increased physical activity. Revealed marked reduction of stage IV sleep. On the background of a reduction in stage IV and frequent awakenings are often noted an increase in the surface phase of slow wave sleep stages (FMS) (I, II stages). Increases the number of transitions from stage to stage, indicating that instability in the cerebral mechanisms for maintaining sleep stages. In addition, the characteristic feature was an increase in the number of awakenings during the last third of the night. A substantial change in the organization of the deepest stages of FMS is also indicated by the phenomenon of ad sleep.