抑郁障碍的睡眠脑电图研究

目的探讨抑郁障碍患者睡眠脑电图的变化。方法应用多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图等技术,对21例抑郁障碍患者的睡眠脑电图(PSG)进行整夜监测,并与22名正常受试者对照。结果抑郁障碍组PSG主要指标表现为睡眠维持率下降(正常组99%±3%,抑郁障碍组90%±5%,P<0.01),第二阶段睡眠降低(正常组57%±5%,抑郁障碍组45%±17%,P<0.05)及快眼动睡眠(REM)睡眠参数存在变异。结论抑郁障碍患者具有PSG多项睡眠脑电指标的改变。其中REM变化是本病的特点。     

强迫症患者睡眠特征初步探讨

目的：探讨强迫症（OCD）患者睡眠特征。方法：对21例OCD患者进行多导睡眠图（PSG）检查，并与20例正常成年人进行对比分析。结果：OCD患者睡眠中觉醒次数、时间增多、觉醒比异常；睡眠效率下降：第1期（SI期）睡眠百分比减少，快速眼动（REM）睡眠时间增加。随着病程的增长，REM睡眠时间减少。结论：OCD患者有睡眠异常现象，与其发病机理有一定的关系。     

抑郁症相关性失眠的临床特征与多导睡眠图研究

目的探讨抑郁症相关性失眠症状的临床特征与抑郁症睡眠的结构特征。方法对符合抑郁症诊断标准,且具有明显失眠症状的患者71例,进行了汉密尔顿抑郁量表、汉密尔顿焦虑量表、匹兹堡睡眠质量指数评定,以及整夜多导睡眠监测,并随机选取30例正常人作为对照组。结果抑郁症相关性失眠患者相对于对照组,睡眠症状方面表现出睡眠潜伏期长、维持时间短、睡眠效率低、睡眠质量差、日间功能受损、过多依赖安眠药。睡眠进程和连续性方面：总睡眠时间（TST）、睡眠效率（SE）、睡眠维持率（SMT）均短于对照组,清醒时间（WASO）、睡眠潜伏期（SL）长于对照组;睡眠结构方面：N1、N2比例长于对照组,N3、REM比例短于对照组;REM指标：REM潜伏期（RL）、REM周期数、REM时间（RT）均短于对照组,REM密度（RD）、REM活动度（RA）、REM强度（RI）均长于对照组。在抑郁症失眠组中,HAMD总分与,TST、TIB、SE、SMT、RL显著负相关;与RD、RA、RI正相关;HAMA总分与TST、TIB、SE、SMT负相关;PSQI总分与TST、TIB、SE、SMT显著负相关;睡眠潜伏期因子与SL、N2％显著负相关;睡眠持续性因子与TST、TIB负相关;催眠药物因子与SE、SMT、SL、N2％正相关。结论抑郁症相关性失眠患者失眠症状与普通失眠症相似;多导睡眠图的结果表明存在睡眠进程、睡眠结构及REM指标系列改变;抑郁的严重程度与REM指标相关,REM睡眠的改变可能是特异性的,可作为抑郁症诊断的参考。     

正常睡眠及失眠的功能神经影像研究进展

50年前发现的快速眼动相（REM）睡眠期使我们对睡眠觉醒调节基础机制的了速解向前推进了一大步,但是不论是脑电图还是多导睡眠图（polysomnography,PSG）都只能反映脑表面的电生理变化,无法涉及不同区域的大脑功能,这也限制了我们对睡眠觉醒机制的进一步探究.然而核医学与睡眠医学的结合为这一领域的深入研究开拓了一个崭新的局面.尽管进展很大,但是绝大多数研究仍处于初级阶段,主要集中在健康者的睡眠与脑功能的关系上,只有个别是针对特殊类型睡眠障碍进行的研究.以下将在描述正常睡眠过程的基础上,回顾核医学（功能神经影像）方法在睡眠与脑功能、原发性失眠和继发性失眠的应用研究.     

失眠症的整夜多导睡眠图监测

目的探索建立失眠症的多导睡眠图(PSG)模式.方法应用日本Nihon Kohden公司的Neurofax-1518K多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图技术,对39例失眠症患者和33名正常对照者进行PSG全夜监测.结果与正常组相比,失眠症组的PSG表现为睡眠总时间减少(正常组464.1±22.9分,失眠症组359.7±31.5分,P＜0.01),睡眠潜伏期延迟(正常组19.9±9.8分,失眠症组31.5±18.4分,P＜0.01),醒觉次数多(正常组1.4±0.7次,失眠症组4.9±2.1次,P＜0.01),睡眠效率低(正常组94.6±5.1%,失眠症组84.7±8.3%,P＜0.01),第一阶段睡眠增加(正常组9.1±1.9%,失眠症组27.9±17.9%,P＜0.01),第二阶段睡眠下降(正常组56.2±4.7%,失眠症组45.9±17.7%,P＜0.01),第3,4阶段睡眠降低(正常组16.7±4.9%,失眠症组9.1±5.1%,P＜0.01),REM睡眠潜伏期缩短(正常组87.8±11.7分,失眠症组53.8±19.7分,P＜0.01).此外,失眠症组有8例(N=8/39,20.5%)的睡眠潜伏期和睡眠效率综合分析正常,但患者主诉"无睡眠感",有"主观性失眠"存在.结论失眠症患者PSG存在睡眠进程、睡眠结构和REM值的变化.睡眠潜伏期延迟和慢波睡眠S1增加具有更高的临床价值.本组研究还发现失眠症患者中有一部分对象可能属于"主观性失眠".     

抑郁症、神经衰弱和正常人的睡眠障碍研究

对３０例抑郁症患者、３０例神经衰弱患者以及１５例境遇性失眠者的多导睡眠图进行研究。结果显示：三组具有失眠主诉的受试者均有某些睡眠指标的异常，同时其失眠症状也与自身的主观体验有明显的关系。与３０例正常受试者对照，抑郁症组快眼动（ＲＥＭ）睡眠潜伏期缩短，ＲＥＭ活动度、强度和密度增高，ＲＥＭ睡眠次数增加，这些改变可能反映了抑郁症的电生理特征。神经衰弱组ＲＥＭ睡眠潜伏期、活动度、强度和密度与抑郁症组相应指标有类似的变化趋势，显示这两种疾病之间有着某种内在联系，其意义有待进一步探讨。     

伴自主神经功能障碍的帕金森病患者的睡眠结构及其与快速眼动睡眠障碍的相关性

目的探讨伴发自主神经功能障碍的帕金森病(PD)患者的睡眠结构及其与快速眼动睡眠障碍(RBD)的关系。方法收集48例PD患者的一般资料。根据皮肤交感反应(SSR)检查,将患者分为SSR正常组及SSR障碍组。应用统一PD评定量表第三部分(UPDRS-Ⅲ)、Hoehn-Yahr(H-Y)分级、汉密尔顿焦虑量表(HAMA_(14))、汉密尔顿抑郁量表(HAMD_(24))、匹兹堡睡眠指数量表(PSQI)、MMSE、蒙特利尔认知评估量表(MoCA)、自主神经症状量表(SCOPA-AUT)评估患者的运动、非运动症状及自主神经功能;RBD筛查量表(RBDSQ)评定患者RBD症状;多导睡眠监测(PSG)记录睡眠参数。结果与SSR正常组比较,SSR障碍组病程显著延长,H-Y分级及HAMA_(14)、HAMD_(24)、PSQI、SCOPA-AUT、RBDSQ量表评分显著升高(P0.05～0.01)。与SSR正常组相比,SSR障碍组患者睡眠效率及非快速眼动期(NREM)-Ⅱ期睡眠百分比显著下降,觉醒指数、NREM-Ⅰ期睡眠百分比、周期性腿动指数(PLMI)显著增高(P0.05～0.01)。SSR障碍组周期性腿动和RBD比率均显著高于SSR正常组(χ~2=4.463,P=0.035;χ~2=8.889,P=0.003)。RBDSQ与SCOPA-AUT评分、NREM-Ⅰ期睡眠百分比、REM期睡眠百分比、呼吸暂停-低通气指数、PLMI和觉醒指数呈正相关(均P0.01),与总睡眠时间、睡眠潜伏期、REM潜伏期、睡眠效率、NREM-Ⅱ期睡眠百分比、NREM-Ⅲ期睡眠百分比呈负相关(均P0.01),与总觉醒时间无相关性。结论伴自主神经功能障碍的PD患者病程长,病情重,容易存在焦虑、抑郁情绪,客观存在睡眠结构紊乱,RBD发生率高。PD患者RBD的严重程度与自主神经功能障碍程度密切相关。     

失眠症患者睡眠质量的主观评估与多导睡眠图参数对比分析

目的 探讨失眠症患者对睡眠质量的主观评估,并通过对多导睡眠图(PSG)睡眠参数的定量分析,对失眠症患者的睡眠状况进行客观评估,进一步将二者进行对比分析.方法 对失眠症患者和健康人各100例运用匹兹堡睡眠质量指数问卷(PSQI)进行评定,并分别进行多导睡眠图的整夜睡眠描记,次日晨起后询问夜间睡眠情况.结果 失眠症组PSQI各成分得分及总分均高于对照组,差异有统计学意义(P＜0.01).与对照组相比,失眠症组的睡眠潜伏期(min)延长(失眠症组43.69±11.54,对照组16.01±10.44)、总睡眠时间(min)减少(失眠症组314.65±91.89,对照组446.41±77.81)、睡眠效率降低(失眠症组64.51%±18.59%,对照组91.32%±3.58%)、快眼动睡眠时间(min)减少(失眠症组33.26±15.61,对照组93.21±21.63),差异有统计学意义(P＜0.01).失眠症组对总睡眠时间的评估较PSG检测值显著减低、对睡眠潜伏期的评估较PSG检测值显著增高,自我评估与实际睡眠情况不一致.结论 失眠症患者睡眠质量较差.失眠症患者的PSG各睡眠参数有特征性的改变,利用PSG检查发现失眠症患者对失眠情况的主客观评估不一致,存在过高估价睡眠潜伏期和过低估价睡眠时间的倾向.     

伴自杀行为抑郁症患者的多导睡眠图研究

目的观察伴有自杀行为抑郁症患者的多导睡眠图(PSG)变化。方法对29例伴有自杀行为抑郁症患者(以下简称抑郁组)的PSG进行整夜测试,并与30名健康成人(NC组)进行对照。结果与NC组相比,抑郁组PSG改变主要为快眼动睡眠睡眠潜伏期(RL)缩短及非眼快动睡眠(NREM)变异(P<0.05)。结论 PSG可用于对伴有自杀行为抑郁症患者的检测。     

失眠症患者主客观睡眠状况分析

目的：探讨失眠症患者主客观睡眠状况及其临床意义。方法：对71例失眠症患者及27例正常对照者进行睡眠调查及全夜多导睡眠图(PSG)检测。结果：失眠症组主观入睡时间、醒觉次数、睡眠潜伏期的评估值较PSG检测值显著增高；主客观入睡时间的评估显著不一致。结论：失眠症患者对失眠障碍主客观评估不一致，在临床诊断时应引起重视。     

Subjective and objective measures of insomnia in the context of traumatic brain injury: a preliminary study

BACKGROUND AND PURPOSE: To compare subjective and objective measures of sleep in traumatic brain injury patients (TBI) suffering from insomnia and in controls. PATIENTS AND METHODS: Fourteen patients with mild to severe TBI were compared to 14 healthy good sleepers. Subjective measures of insomnia were obtained from a sleep diary (morning questionnaire), and objective measures from two nights of polysomnography (PSG). RESULTS: All subjective measures of sleep revealed significant sleep disturbance in the TBI group. TBI patients with insomnia have a tendency to overestimate their sleep disturbance compared to PSG measures of sleep. With PSG, 10 out of 14 participants with TBI could be defined as having objective insomnia. Nonetheless, when groups were compared, no significant differences were found on sleep continuity variables, although large effect sizes were seen for several measures suggesting sleep fragmentation. In terms of sleep architecture, no significant differences were found in the percentage of stage 2, slow-wave (stages 3 and 4), and rapid eye movement (REM) sleep, but a higher proportion of stage 1 sleep was found in the TBI participants. When patients using psychotropic medication were excluded, TBI patients were found to have more awakenings lasting longer than 5min and a shorter REM sleep latency. CONCLUSIONS: These results are similar to those found in patients with either primary insomnia or insomnia related to depression.     

肌萎缩侧索硬化症患者睡眠障碍及睡眠呼吸障碍特点分析

目的通过多导睡眠图监测肌萎缩侧索硬化症患者睡眠结构和睡眠呼吸事件,探讨其睡眠障碍和睡眠呼吸障碍特点。方法共36例患者根据是否存在延髓症状分为肢体受累组(14例)和延髓麻痹组(22例),记录一般资料以及睡眠障碍和睡眠呼吸障碍相关主诉,包括入睡困难、睡眠维持困难或早醒、呼吸不畅或鼾症、夜尿症、不宁腿综合征、肌肉疼痛等;Appel肌萎缩侧索硬化症量表(AALS)评价延髓功能、呼吸功能、上下肢肌力和肌肉功能;多导睡眠图监测脑电图、眼动图、心电图、肌电图、体位、鼾声、口鼻气流量、胸腹式呼吸和指端脉搏血氧饱和度,以及睡眠相关参数包括总睡眠时间、睡眠效率、睡眠潜伏期、觉醒次数、非快速眼动睡眠期各期和快速眼动睡眠期比例、睡眠呼吸暂停低通气指数。Pearson相关分析评价快速眼动睡眠期睡眠呼吸暂停低通气指数和周期性腿动与临床资料和AALS评分的相关性。结果延髓麻痹组患者AALS总评分(P=0.007)、延髓功能评分(P=0.000)和呼吸功能评分(P=0.000)高于,上肢肌力(P=0.016)低于肢体受累组。两组患者均出现睡眠结构紊乱,表现为睡眠片段化,其中延髓麻痹组觉醒次数多于(P=0.027)、快速眼动睡眠期比例低于(P=0.009)、周期性腿动次数少于(P=0.020)肢体受累组;两组患者睡眠呼吸障碍主要表现为低通气,其中延髓麻痹组睡眠呼吸暂停低通气指数(P=0.038)、快速眼动睡眠期和非快速眼动睡眠期睡眠呼吸暂停低通气指数(P=0.031,0.049)高于肢体受累组。Pearson相关分析显示,快速眼动睡眠期睡眠呼吸暂停低通气指数与病程(r=0.654,P=0.028)以及AALS总评分(r=0.458,P=0.034)、延髓功能评分(r=0.572,P=0.030)、呼吸功能评分(r=0.756,P=0.002)呈正相关,周期性腿动与病程(r=0.574,P=0.030)以及AALS总评分(r=0.321,P=0.042)、上肢肌肉功能(r=0.656,P=0.028)和下肢肌肉功能(r=0.754,P=0.015)评分呈正相关。结论肌萎缩侧索硬化症患者存在失眠、睡眠呼吸障碍、周期性肢体运动障碍等多种形式的睡眠障碍。多导睡眠图可以监测到睡眠呼吸障碍,为尽早进行无创性正压通气提供临床依据。     

快速动眼睡眠型和非快速动眼睡眠型阻塞性睡眠呼吸暂停综合征患者的临床特征分析

目的比较快速动眼睡眠(REM)型和非REM(NREM)型阻塞性睡眠呼吸暂停综合征(OSA)患者的临床特征、多导睡眠监测(PSG)参数和血清学指标间的差异。方法收集2018年1月至2019年6月住院且PSG提示总呼吸暂停低通气指数(AHI)≥5的OSA患者129例。统计REM期AHI值(AHI_REM)和NREM期AHI值(AHI_NREM)。依据Oksenberg分型,将AHI_REM/AHI_NREM≥2分为REM-OSA组,AHI_REM/AHI_NREM﹤2分为NREM-OSA组。观察指标包括患者性别、年龄、体重指数(BMI)、首诊符合率、Epworth嗜睡量表(ESS)、匹兹堡睡眠质量指数(PSQI)、抑郁自评量表(SDS)和焦虑自评量表(SAS)、PSG参数、血清超敏C反应蛋白、IL-6及二氧化碳结合率等。结果两组患者在性别、年龄、BMI、首诊符合率、SAS分值、AHI_NREM、总AHI值、最低动脉血氧饱和度(L-SaO₂)、血氧饱和度低于90%持续时间百分比(CT90)、血清超敏C反应蛋白和二氧化碳结合率的差异具有统计学意义(均P<0.05)。相关性分析显示,OSA患者L-SaO₂与BMI、PSQI分值、总睡眠时间、睡眠效率、NREM 2期所占睡眠总时间百分比、总AHI值、AHI_NREM、AHI_REM、AHI_REM/AHI_NREM比值、血清超敏C反应蛋白分别存在负相关性(均P<0.05);OSA患者总AHI值与BMI、睡眠效率、AHI_NREM、AHI_REM、血清超敏C反应蛋白分别存在正相关性(均P<0.05),而与性别、AHI_REM/AHI_NREM比值分别存在负相关性(均P<0.05)。结论与NREM-OSA相比,REM-OSA患者年龄偏低,女性占比较高,体重偏轻,L-SaO₂更低,CT90更大,同时REM-OSA患者超敏C反应蛋白水平和血清二氧化碳结合率较高。两组最低氧减皆发生在REM睡眠期,与睡眠质量存在相关性。因此REM-OSA并不是单纯数学意义上的分型,它更可能是被忽视的诊断,积极的早期识别和处理可能为患者带来获益。     

Sleep characteristics of menopausal insomnia: a polysomnographic study

Although menopausal insomnia is of clinical significance, the essential features of this form of disrupted sleep are poorly understood. The aim of the present study was to identify the sleep characteristics of menopausal insomnia by using overnight polysomnography (PSG). Twenty-one subjects with menopausal insomnia (MI) and 13 sex- and age-matched normal control (NC) subjects without sleep complaints took part in the present study. All MI and NC subjects underwent PSG on two consecutive nights. In comparison with NC, MI subjects had non-specific findings such as significantly shorter total sleep time, longer sleep latency, higher wake time after sleep onset, and lower sleep efficiency. As for rapid eye movement (REM) sleep variables, MI subjects had significantly shorter total REM sleep time, fewer numbers of REM sleep periods, longer REM latency, and higher REM density than did the NC subjects. As for the time course of REM density, REM density during the first 3 h period of nocturnal sleep was significantly higher for MI than for NC subjects. Unlike NC subjects, REM density for MI subjects did not tend to rise progressively during nocturnal sleep. The MI subjects had objective evidence of disrupted sleep and the most striking characteristics of this dysfunction were observed in REM sleep variables. The sleep characteristics of MI subjects were found to differ in REM sleep variables from those of patients with major depression (except for REM density). Menopausal insomnia patients appear to be similar to patients with generalized anxiety disorder accompanied by severe sleep disruption. These data lend support to the clinical distinction between menopausal insomnia and insomnia associated with major psychiatric disorders.     

Half of patients with obstructive sleep apnea have a higher NREM AHI than REM AHI

BACKGROUND AND PURPOSE: To determine the percentage of sequential patients with obstructive sleep apnea with a higher non-rapid eye movement (NREM) apnea-hypopnea index (AHI) than rapid eye movement (REM) AHI and those with a higher REM AHI than NREM AHI, and to look for factors that might influence the AHI to be higher in one of these two groups versus the other and thus ascertain the factors that cause an AHI to be higher in NREM than REM. A high body mass index (BMI) and a supine body position are well known as exacerbating factors for obstructive sleep apnea (OSA). Males, as well as older individuals, are generally more predominantly affected with OSA than females. Usually OSA is worse in REM sleep than in NREM sleep, although this is not always true. METHODS: A retrospective study of sequential patients from one month's admission to a single sleep laboratory was conducted. We determined the age, sex, BMI, body position, duration of apnea, amount of time spent in REM and oxygen desaturation in patients who had a higher NREM AHI than REM AHI versus those who had a higher REM AHI than NREM AHI. To minimize variability, the sleep studies were scored by a single individual. RESULTS: A higher NREM AHI than REM AHI was found in 50% of the 66 patients with OSA. Males predominated in each group and there was no age difference between the groups. Although AHI for both groups tended to become higher with an increase in BMI, the BMI was not statistically different between the two experimental groups. OSA was worse in the supine position in both experimental groups consistent with previous literature. Percentage of time spent in REM or the duration of the apnea did not determine whether a patient fell into the NREM AHI>REM AHI group versus the REM AHI>NREM AHI. The severity of oxygen desaturation was not significantly different between the NREM AHI>REM AHI versus the REM AHI>NREM AHI group. However, when we combined and analyzed the two groups as a whole, the apneas were longer in REM, consistent with previous literature. CONCLUSIONS: Although it is well known that OSA is generally worse in REM sleep because of the degree of desaturation and duration of apnea, a higher NREM AHI than REM AHI is found in up to one half of individuals. Most of the usual predictors for severity of OSA as a whole did not discriminate these groups. Further work needs to be done to determine the factors that discriminate these two groups and thus make AHI higher in NREM than REM.     

睡眠时相相关阻塞性睡眠呼吸暂停对急性脑梗死患者睡眠结构及预后的影响

目的 探讨REM期与非快动眼睡眠（non-rapid eye movement，NREM）期相关OSA对急性脑梗死（acute ischemic stroke，AIS）患者睡眠结构及预后的影响。 方法 回顾性收集2011年2月-2018年8月于苏州大学附属第二医院就诊且完成PSG的AIS患者，收集 的数据包括一般资料，情绪、认知、睡眠量表评估，MRI 、PSG检查，出院时功能恢复情况（应用NI HSS 量表和mRS量表评估）及3个月预后（应用mRS量表评估）。根据总睡眠期、REM期和NREM期睡眠AHI， 将患者分为单纯脑梗死组、脑梗死合并REM期相关OSA组和脑梗死合并NREM期相关OSA组，对3组一 般资料、临床量表评分、睡眠数据及预后情况进行单因素和多因素分析，观察睡眠不同时相OSA对患 者睡眠结构及预后的影响。 结果 最终纳入110例患者，其中单纯脑梗死组30例（27.3%），脑梗死合并REM期相关OSA组15例 （13.6%），脑梗死合并NREM期相关OSA组65例（59.1%）。脑梗死合并NREM期相关OSA组BMI高于单纯 脑梗死组。脑梗死组病灶部位多位于大脑半球，脑梗死合并REM期相关OSA组病灶依次位于脑干、大 脑半球、间脑。与单纯脑梗死组相比，脑梗死合并NREM期相关OSA组NREM1期睡眠时间及比例高， 慢波睡眠时间及比例低。与脑梗死合并REM期相关OSA组相比较，脑梗死合并NREM期相关OSA组微 觉醒指数、呼吸相关微觉醒指数、自发相关微觉醒指数高，上述差异均具有统计学意义。各组间3个 月后mRS评分差异无统计学意义。Logistic回归分析提示入院时高NIHSS评分、低受教育水平、高BMI是脑 梗死患者预后不良的独立危险因素。 结论 NREM期相关OSA会改变脑梗死患者的睡眠结构，使其浅睡眠1期延长，深睡眠（NREM 3期 和4期）缩短，睡眠片段化，此种改变可能会导致脑梗死患者预后更差。     

Analysis of the first night effect and sleep parameters in medically refractory epilepsy patients

OBJECTIVES: To assess the first night effect (FNE) and compare sleep stage proportions to normative values in a sample of medically refractory epilepsy patients. PATIENTS AND METHODS: Sleep parameters of 53 epilepsy patients, ages (18-56, mean: 34+/-12, 25 females 28 men), who underwent two consecutive nights of polysomnography (PSG) were compared. Non-rapid eye movement (NREM) stage 3 and NREM stage 4 were combined as slow wave sleep (SWS). Sleep efficiency, sleep latency, rapid eye movement (REM) latency, number of stage shifts, total minutes and proportion of total sleep time for stage 1, stage 2, SWS, and REM sleep were compared between the 2 nights. RESULTS: SWS was the only parameter that differed between nights 1 and 2 for both total minutes (P=0.02) and proportion of total sleep time (P=0.01), although the means for both nights were within the normative range. Comparing sleep proportions to normative values indicates that our patients had increased NREM stage 1 and decreased REM sleep. CONCLUSIONS: We observed a minimal FNE in this sample of epilepsy patients manifested by reduced SWS. Multiple PSGs to accommodate the FNE may not be necessary in this population.     

不同病程原发性失眠症患者非快速眼运动睡眠δ波对比分析

目的 对比分析不同病程原发性失眠症患者非快速眼运动（Non Rapid Eye Movement,NREM）睡眠δ波分布特点.方法 按照美国精神病学会制定的《精神障碍诊断和统计手册（DSM-Ⅳ）》关于失眠病程划分标准,收集急性原发性失眠（API）组82例,亚急性原发性失眠（SPI）组80例,慢性原发性失眠（CPI）组85例,正常睡眠组（NS）30例.并检测4组受试者正常作息条件及睡眠限制条件下非快速眼运动睡眠δ波分布情况.结果 正常作息条件下,API组、SPI组及CPI组患者与NS组比较均存在非快速眼运动睡眠δ波减少（P＜0.05）,API组、SPI组及CPI组患者之间δ波对比差异无统计学意义（P＞0.05）.在睡眠限制条件下,API组、SPI组非快速眼运动睡眠δ波与NS组比较差异无统计学意义（P＞0.05）,CPI组δ波小于NS组（P＜0.05）.结论 API组、SPI组及CPI组患者均存在睡眠平衡压力不足情况,睡眠限制能提高API组及SPI组睡眠平衡压力,但无法提高CPI组患者睡眠平衡压力.