11例1型发作性睡病睡眠结构的多导睡眠图分析

目的 探讨1型发作性睡病夜间睡眠的结构特点。 方法 收集1型发作性睡病患者11例和有日间嗜睡但排除相关睡眠疾病的儿童20例。使用多导睡眠监测仪进行整夜(>7 h)连续包括16导脑电图的视频多导睡眠监测(PSG),并于次日进行5次多次小睡潜伏期试验(MSLT)。 结果 与对照组比较,1型发作性睡病组在入睡后觉醒时间占总卧床时间的百分比(WASO%)、非快速眼球运动(NREM)1期睡眠期比例(N1%)增加[17.60(13.10)vs 5.00(12.80),P<0.05;(19.93±12.00)vs(10.12±5.63),P<0.05],入睡潜伏期、快速眼球运动(REM)睡眠潜伏期缩短[5.50 min(11.50 min)vs 13.50 min(22.87 min),P<0.05;(93.50±106.61)min vs(157.47±65.74)min,P<0.05],NREM 3期睡眠期比例(N3%)减少[(17.50±5.60)vs(24.48±7.60),P<0.05]; 但睡眠效率、NREM 2期睡眠期比例(N2%)、REM睡眠期比例(R%)、醒觉指数、睡眠期周期性腿动指数、睡眠呼吸暂停/低通气指数等差别无统计学意义。 结论 1型发作性睡病患者存在夜间睡眠结构紊乱、睡眠片段化现象。

A Study of Sleep Architecture in 11 Cases of Type 1Narcolepsy by Polysomnogram

Objective To explore the characteristics of night sleep structure in type 1 narcolepsy. Methods The enrolled subjects were: 11 type 1 narcolepsy patients and 20 controls who complained of daytime sleepiness,but with no sleep related diseases. All subjects attended neurology clinic from January 2007 to December 2017. All subjects underwent overnight(>7 h)consecutive video-polysomnography(vPSG)with 16 channel electroencephalograph(EEG)and multiple sleep latency test(MSLT)including five nap opportunities in the next day. Results Compared with the control group, type 1 narcolepsy had more wake time after sleep onset(WASO)in percentage of time in bed(WASO%)and increased NREM 1 sleep period(N1)%[17.60(13.10)vs 5.00(12.80),P<0.05;(19.93±12.00)vs(10.12±5.63), P<0.05], shorter sleep latency and REM sleep latency[5.50 min(11.50 min)vs 13.50 min(22.87 min), P<0.05;(93.50±106.61)min vs(157.47±65.74)min,P<0.05], less NREM 3 sleep period(N3)%[(17.50±5.60)vs(24.48±7.60), P<0.05). There was no significant difference in sleep efficiency, NREM 2 sleep period(N2)%, REM sleep period(R)%, awakening index, sleep periodic leg movement index, and sleep apnea hypopnea index(AHI). Conclusion There are abnormal sleep structure in night sleep and sleep fragmentation in patients with type 1 narcolepsy patients.