Epworth Sleepiness Scale and Polysomnographic Evaluation of Dysthymic Women with Chronic Insomnia

Aylin Bican; Ozan Vahap Kotan; İbrahim Bora; Cengiz Akkaya; Ender Çarkungöz; Selçuk Kırlı

Aylin Bican¹, Ozan Vahap Kotan², İbrahim Bora¹, Cengiz Akkaya², Ender Çarkungöz³, Selçuk Kırlı²

¹Faculty Of Medicine, University Of Uludag, Department Of Neurology, Bursa, Turkey
²Faculty Of Medicine, University Of Uludag, Department Of Psychiatry, Bursa, Turkey
³Faculty Of Medicine, University Of Uludag, Department Of Biostatistics, Bursa, Turkey

Keywords: Dysthymic disorder, polysomnography, sleep disorders.

Abstract

OBJECTIVE: In patients with dysthymic disorder (DD), sleep problems are assessed as a part of their depressive state, and different treatable conditions, such as other primary sleep disorders, are often skipped. We aimed to determine symptoms related to daytime sleepiness and polysomnographic findings in dysthymic women with chronic insomnia and to find out whether or not there is an accompanying sleep disorder. We suggest that pathologies that can lead to sleep problems in dysthymic patients should be searched, and to this end, application of the Epworth sleepiness scale (ESS) and polysomnography examination should be used much more frequently

METHODS: We included 20 female dysthymic patients with complaints of chronic sleep problems who had been under follow-up at Uludag University Hospital Psychiatry Outpatient Clinic for at least the last two years. Twenty healthy female volunteers, aged 18-65 years, were included in the study as the control group. ESS and polysomnography examination were applied in all patients.

RESULTS: When patients with DD and healthy controls were compared, significant differences in ESS scores and ratios of sleep phases were determined between groups. DD patients had higher ESS scores and higher ratios of rapid eye movements (REM), non-REM-1 (Stage 1), non-REM-2 (Stage 2) phases and lower ratios of slow wave sleep (Stage 3 + Stage 4).

CONCLUSION: The findings of our study suggest that there are structural sleep changes in dysthymic patients, but no direct connection between sleep variables and depressive states is evident.