468例癫癎患者睡眠期癎样放电与睡眠结构变化分析

目的：观察癫 患者的睡眠时相与 样放电的关系，并初步探讨癫 异常脑波活动对睡眠的影响。方法：对４６８例癫　患者进行２４小时动态脑电图（ＡＥＥＧ）监测，观察发作间期清醒与睡眠脑电图　样放电的发作频率，分析５８例癫　患者及对照组睡眠脑电图中睡眠时程、觉醒次数、睡眠纺锤波的变化。结果：４６８例患者中出现　样放电３６２例，睡眠期　样放电检出率８８％，觉醒期检出率５８％。样放电主要出现于ＮＲＥＭ睡眠Ⅰ－Ⅱ期。与对照组比较，癫　组ＮＲＥＭ　Ⅰ－Ⅱ睡眠期延长，ＮＲＥＭ Ⅲ－Ⅳ期缩短；觉醒次数增加，觉醒次数与　样放电频率呈正相关；并有睡眠纺锤波减少及不对称。结论：癫　患者的　样放电主要出现于ＮＲＥＭ睡眠Ⅰ－Ⅱ期，癫　活动对睡眠有一定影响，癫　患者睡眠质量下降。     

动态脑电图对癫癎诊断的应用价值

目的:观察癫癎患者自然睡眠时相与癎样放电的关系,探讨脑电Holter 24 h监测即俗 称的动态脑电图(AEEG)在癫癎的诊断及分型中的应用价值。方法:回顾分析761例癫癎患者24 h AEEG监测资料,对发作间期清醒与睡眠期脑电图癎样放电的发作频率进行比较。结果:761例患者中 检出癎样放电553例,睡眠期检出495例(检出率89.5％),觉醒期检出309例(55.9％),癎样放电主要 出现于NREM睡眠Ⅰ-Ⅱ期;93例患者AEEG监测后发作类型得到了修正。结论:睡眠期癎样放电检 出率明显高于觉醒期,癫癎患者睡眠期癎样放电主要出现于NREMⅠ-Ⅱ期,AEEG有助于癫癎的诊 断及分型。     

视频录像脑电图对癫癎诊断的应用价值

目的：探讨视频录像脑电（VEEG）的睡眠时相与癫癎的关系及其对癫癎病的诊断价值。方法：225例常规脑电（EEG）无癎样放电患者分为癫癎组和可疑癫癎组进行VEEG监测并分析结果。结果：临床癫癎组癎样放电总发生率为59％，可疑癫癎组总发生率为3％，癫癎样放电主要出现于NREM睡眠Ⅰ-Ⅱ期。结论：睡眠期癎样放电检出率明显高于觉醒期，VEEG可提高癎样放电的检出率，对癫癎的诊断有重要意义。     

140例小儿癫癎与可疑癫癎的24h动态脑电图监测报告

目的：探讨小儿动态脑电图(AEEG)的睡眠时相与癫痢的关系及其对小儿癫痫病的诊断价值。方法：140例常规脑电图(EEG)无痫样放电患儿分别为临床诊断癫痫组和可疑癫痫组，进行24h AEEG监测，并观察觉醒期和睡眠期AEEG痫样放电的分布情况。结果：AEEG痫样放电发生率在临床诊断小儿癫痫组占55．9％，小儿可疑癫痫组占37．5％。痫样放电多见于NREMⅠ—Ⅱ期，并见有NREMⅠ—Ⅱ期明显延长，而NREMⅢ—Ⅳ期相对缩短。结论：小儿癫痫病痫样放电主要发生于NREMⅠ—Ⅱ期。AEEG可提高小儿癫痫病痫样放电的检出率，对小儿癫痫病的诊断有重要意义。     

癫癎患者脑电图癎样放电相关因素及临床意义

目的：分析癫癎患者脑电图癎样放电的相关因素及临床意义。方法：对用２４ ｈ 便携式磁带记录脑电图（ＡＥＥＧ） 检出癎样放电的１６２ 例癫癎患者进行相关因素分析。结果：在临床表现为全面性发作患者,ＡＥＥＧ 可检出有明确定位价值的颅内局灶性异常。睡眠时期癎样放电检出率为８０ ％ ,癎样放电主要出现于ＮＲＥＭⅠ—Ⅱ期（７９ ％ ） ,清醒期及睡眠期均出现癎样放电的７４ 例患者中其局灶性异常（６７ ％ ） 均出现于睡眠期,癎样放电仅出现于睡眠期患者的ＡＥＥＧ 局灶性异常率为８２ ％ （４５／５５） 。结论：ＡＥＥＧ 对癫癎有重要的诊断价值,对于检出有夜间发作倾向的部分性癫癎的癎样放电意义更大。     

116例癫痫患者的动态脑电图监测报告

目的 为了探讨动态脑电图对于癫痫的临床价值.方法 对116例癫痫患者的动态脑电图监测结果进行分析.结果 116例癫痫患者中检出痫样放电89例,检出率76.1%,但不同发作类型间痫样放电检出率比较,差异无显著性意义(P>0.05),睡眠期检出痫样放电109例(检出率93.9%),觉醒期检出54例(检出率46.5%),痫样放电主要出现在NREM睡眠Ⅰ～Ⅱ期.结论 动态脑电图能明显提高癫痫患者痫样放电的检出率,对癫痫的诊断、鉴别诊断、分型、指导用药及癫痫外科治疗的术前监测均有重要的临床价值.     

116例癫痫患者的动态脑电图监测报告

目的为了探讨动态脑电图对于癫痫的临床价值。方法对116例癫痫患者的动态脑电图监测结果进行分析。结果 116例癫痫患者中检出痫样放电89例,检出率76.1%,但不同发作类型间痫样放电检出率比较,差异无显著性意义（P〉0.05）,睡眠期检出痫样放电109例（检出率93.9%）,觉醒期检出54例（检出率46.5%）,痫样放电主要出现在NREM睡眠Ⅰ～Ⅱ期。结论动态脑电图能明显提高癫痫患者痫样放电的检出率,对癫痫的诊断、鉴别诊断、分型、指导用药及癫痫外科治疗的术前监测均有重要的临床价值。     

老年迟发性癫Xian发作的病因、临床表现及脑电图特征分析

目的：探讨老年迟发性癫Xian发作的病因、临床特点及脑电图特征。方法：对98例老年迟发性癫Xian发作患者的病因、临床发作类型及治疗结果进行统计分析。结果：73例有明确病因，分别为脑血管病45例，脑肿瘤16例，脑外伤5例，脑萎缩5例，血液病2例；临床发作为部分性发作68例（单纯部分性发作44例，复杂部分性发作24例），全面性发作26例，不能归类的发作4例；脑电图正常21例，异常77例，异常脑电图主要表现为低至中幅慢波增多，呈弥漫性或局限性分布，77例异常脑电图中9例出现癫Xian样放电，临床疗效：完全控制44例（45％），部分控制24例（25％），无效10例（10％），死亡20例（20％）。结论：老年迟发性癫Xian大部分病因明确。临床以部分性发作为主，脑电图以慢波活动为背景，癫Xian样放电阳性率低，临床完全控制率低。     

老年人迟发性癫Xian发作的临床及脑电图分析

目的：探讨老年人迟发性癫Xian发作的临床及脑电图特点。方法：回顾性分析80例老年人迟发性癫Xian的临床及脑电图资料。结果：癫Xian发作的可能因为脑血管病41例（脑梗死30例、脑出血11例）,脑肿瘤19例,脑外伤4例,脑萎缩8例。癫Xian发作的类型为全身强直阵挛发作48例;强直阵挛发作持续状态2例,失神发作6例,单纯运动性发作17例,单纯体感性发作7例。脑电图正常7例,异常73例。异常脑电图主要表现为弥漫性慢波活动22例,局限于一侧半球的慢波活动34例,散在或阵发性棘波、尖波或棘慢、尖慢综合波49例。结论：脑血管病（脑梗死、脑出血）、脑肿瘤是老年迟发性癫Xian发作的主要原因。癫Xian发作以全身强直阵挛发作为主。脑电图异常率高,主要表现为在弥漫性慢波活动基础上出现癫Xian样放电。     

癫痫的睡眠动态脑电图临床应用价值

目的:探讨睡眠期动态脑电图(AEEG)在癫痫诊断中的作用。方法:利用 AEEG对836例癫痫患者自然睡眠期脑电波变化进行监测、分析。结果:正常106例 (12.7％),非特异性异常61例(7.3％),痫样波发放669例(80.0％),总异常730例 (87.3％)。痫样波出现于清醒期84例(12.5％),睡眠期408例(61.0％)。睡眠期明显高 于清醒期P<0.01。而睡眠期(NREM Ⅰ-Ⅱ期)占多数473／585例(80.7％)。结论:癫 痫和睡眠密切相关,通过自然和药物诱发睡眠,有助于提高癫痫脑电图阳性率,尤其是自然 睡眠AEEG对癫痫的定位诊断和分类更具有重要意义。对临床诊断困难的非典型发作及各种 不常见类型癫痫的作用更加突出,甚至起着决定性的作用。     

Exposure to relaxing words during sleep promotes slow-wave sleep and subjective sleep quality

Our thoughts alter our sleep, but the underlying mechanisms are still unknown. We propose that mental processes are active to a greater or lesser extent during sleep and that this degree of activation affects our sleep depth. We examined this notion by activating the concept of “relaxation” during sleep using relaxation-related words in 50 healthy participants. In support of our hypothesis, playing relaxing words during non-rapid eye movement sleep extended the time spent in slow-wave sleep, increased power in the slow-wave activity band after the word cue, and abolished an asymmetrical sleep depth during the word presentation period. In addition, participants reported a higher sleep quality and elevated subjective alertness. Our results support the notion that the activation of mental concepts during sleep can influence sleep depth. They provide a basis for interventions using targeted activations to promote sleep depth and sleep quality to foster well-being and health.     

Idiopathic central sleep apnea during REM sleep

Idiopathic central sleep apnea during rapid eye movement (REM) sleep is an extremely rare condition and only two cases have been reported so far. We present the case of a male patient who presented with chronic insomnia. Blood gas analysis during wakefulness suggested the presence of hypocapnia. Polysomnographic examination revealed central sleep apnea occurring predominantly during REM sleep. The patient responded well to continuous positive airway pressure (CPAP) at a pressure of 6 cmH₂O as well as to acetazolamide therapy.     

Assessment of obstructive sleep apnea-related sleep fragmentation utilizing deep learning-based sleep staging from photoplethysmography

Study ObjectivesTo assess the relationship between obstructive sleep apnea (OSA) severity and sleep fragmentation, accurate differentiation between sleep and wakefulness is needed. Sleep staging is usually performed manually using electroencephalography (EEG). This is time-consuming due to complexity of EEG setup and the amount of work in manual scoring. In this study, we aimed to develop an automated deep learning-based solution to assess OSA-related sleep fragmentation based on photoplethysmography (PPG) signal.MethodsA combination of convolutional and recurrent neural networks was used for PPG-based sleep staging. The models were trained using two large clinical datasets from Israel (n = 2149) and Australia (n = 877) and tested separately on three-class (wake/NREM/REM), four-class (wake/N1 + N2/N3/REM), and five-class (wake/N1/N2/N3/REM) classification. The relationship between OSA severity categories and sleep fragmentation was assessed using survival analysis of mean continuous sleep. Overlapping PPG epochs were applied to artificially obtain denser hypnograms for better identification of fragmented sleep.ResultsAutomatic PPG-based sleep staging achieved an accuracy of 83.3% on three-class, 74.1% on four-class, and 68.7% on five-class models. The hazard ratios for decreased mean continuous sleep compared to the non-OSA group obtained with Cox proportional hazards models with 5-s epoch-to-epoch intervals were 1.70, 3.30, and 8.11 for mild, moderate, and severe OSA, respectively. With EEG-based hypnograms scored manually with conventional 30-s epoch-to-epoch intervals, the corresponding hazard ratios were 1.18, 1.78, and 2.90.ConclusionsPPG-based automatic sleep staging can be used to differentiate between OSA severity categories based on sleep continuity. The differences between the OSA severity categories become more apparent when a shorter epoch-to-epoch interval is used.     

Nasal and sleep cycle--possible synchronization during night sleep

Regular cyclic changes in nostril airflow due to a nasal congestion and decongestion are known in literature as nasal cycle. Registration of breathing from each nostril separately gives possibility to registrate moments of alternative change of airflow of nostrils and periods of nasal cycle. This registration during night sleep shows that the length of these periods are about 1.5h, 3.0 h and 4.5h. The length of these periods are multiple of mean length of sleep cycle--about 1.5h. The alternative change of airflow through nostrils occurs through some of REM stages of the sleep. This shows, that during the night sleep becomes synchronization of nasal and sleep cycles in some of the REM phases of sleep. As a result--length of periods of the nasal cycle are one or more length of sleep cycle.     

Age affects sleep microstructure more than sleep macrostructure

It is well known that the quantity and quality of physiological sleep changes across age. However, so far the effect of age on sleep microstructure has been mostly addressed in small samples. The current study examines the effect of age on several measures of sleep macro‐ and microstructure in 211 women (22–71 years old) of the ‘Sleep and Health in Women’ study for whom ambulatory polysomnography was registered. Older age was associated with significantly lower fast spindle (effect size f² = 0.32) and K‐complex density (f² = 0.19) during N2 sleep, as well as slow‐wave activity (log) in N3 sleep (f² = 0.21). Moreover, total sleep time (f² = 0.10), N3 sleep (min) (f² = 0.10), rapid eye movement sleep (min) (f² = 0.11) and sigma (log) (f² = 0.05) and slow‐wave activity (log) during non‐rapid eye movement sleep (f² = 0.09) were reduced, and N1 sleep (f² = 0.03) was increased in older age. No significant effects of age were observed on slow spindle density, rapid eye movement density and beta power (log) during non‐rapid eye movement sleep. In conclusion, effect sizes indicate that traditional sleep stage scoring may underestimate age‐related changes in sleep.     

Isolated sleep paralysis elicited by sleep interruption.

We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy.