共查询到20条相似文献,搜索用时 31 毫秒
1.
Jana R. Cooke Sonia Ancoli-Israel Lianqi Liu Jose S. Loredo Loki Natarajan Barton S. Palmer Feng He Jody Corey-Bloom 《Sleep medicine》2009,10(10):1101-1106
ObjectivePatients with Alzheimer’s disease (AD) and obstructive sleep apnea (OSA) experience disrupted sleep. This study examined the effect of continuous positive airway pressure (CPAP) on sleep parameters in AD patients with OSA.MethodsA randomized placebo-controlled trial of 3 weeks of therapeutic CPAP (tCPAP) vs. 3 weeks placebo CPAP (pCPAP) followed by 3 weeks tCPAP in patients with AD and OSA. Polysomnography data from screening after one night and after 3 weeks of treatment were analyzed. Records were scored for percent of each sleep stage, total sleep time (TST), sleep efficiency (SE), sleep period (SP), time in bed (TIB), sleep onset (SO), wake time after sleep onset (WASO), and arousals. A randomized design comparing one night of pCPAP to tCPAP and a paired analysis combining 3 weeks of tCPAP were performed.ResultsFifty-two participants (mean age = 77.8 years, SD = 7.3) with AD and OSA were included. After one treatment night, the tCPAP group had significantly less % Stage 1 (p = 0.04) and more % Stage 2 sleep (p = 0.02) when compared to the pCPAP group. In the paired analysis, 3 weeks of tCPAP resulted in significant decreases in WASO (p = 0.005), % Stage 1 (p = 0.001), arousals (p = 0.005), and an increase in % Stage 3 (p = 0.006).ConclusionIn mild to moderate AD patients with OSA, the use of tCPAP resulted in deeper sleep after just one night, with improvements maintained for 3 weeks. 相似文献
2.
Happe S Klösch G Lorenzo J Kunz D Penzel T Röschke J Himanen SL Gruber G Zeitlhofer J 《Journal of neurology》2005,252(8):936-943
Introduction
Subjective
sleep perception, as measured
against objective parameters such
as those obtained by polysomnography,
have not been examined
thoroughly to date. Little is known
about subjective sleep perception
in patients with chronic somatic
diseases.
Patients and methods
Patients
with Parkinson’s disease
(PD) and healthy elderly controls
filled in a sleep log over 14 days,
which included a self–rating questionnaire
concerning sleep and
quality of time awake, sleep times
and somatic complaints. All participants
underwent polysomnography
in the sleep lab on nights 7 and
8, and slept all other nights at
home.
Results
Seventeen patients
with PD (64 ± 6 years, 6 female,
Hoehn and Yahr median = 2), and
62 healthy controls of the same age
without sleep disturbances (64 ± 8
years, 36 female) were included. Patients
with PD showed reduced
subjective sleep (p = 0.001) and
quality of time awake (p = 0.02),
decreased sleep duration (p = 0.01)
and reduced sleep efficiency
(p = 0.004) compared with the controls.
Subjective sleep efficiency at
home was no different from that in
the sleep lab for both groups. Patients
with PD reported more somatic
complaints (p = 0.001) than
controls but did not show a firstnight
effect.
Conclusion
In summary,
patients with PD have subjectively
and objectively disturbed
sleep as compared to healthy controls
of the same age. However, they
may not rate this poor sleep as
much changed from their baseline
sleep at home, and they have more
somatic complaints. Increasing
sleep efficiency might be of importance
in PD patients, as it shows an
association with subjective quality
of time awake in the morning. 相似文献
3.
《Sleep medicine》2014,15(1):33-41
Background and objectivesThe pathophysiologic aspects of parasympathetic nerve (PN) function during sleep in patients with obstructive sleep apnea (OSA) studied by classical power spectrum analysis on heart rate variability (HRV) are highly controversial. The controversy is attributed to methodologic concerns, such as poor time resolution involved in power spectrum analysis. We aimed to establish the appropriate method for the investigation of PN function in OSA patients with apneas and hypopneas using instantaneous time–frequency analysis with complex demodulation (CD) and sufficient time resolution.MethodsA total of 30 patients with PSG-confirmed mild to severe OSA were recruited for the analysis of frequency spectra contained in R-R intervals (RRI) of overnight electrocardiograph (ECG) tracings. High-frequency (HF) domains ranging between 0.15 and 0.40 Hz were selected for analysis. Among these domains, the HF domain with the maximum instantaneous amplitude was defined as the main HF peak and was used as the surrogate marker of PN discharge. Based on density spectrum array (DSA) map for main HF peak constructed with a time scale of 1 s and a frequency resolution of 0.002 Hz (HF-DSA map), the shift in central frequency (CF) of main HF peak over time was continuously monitored. When the main HF peak with the same CF lasted for more than 20 s or 5 min on HF-DSA map, the PN function was considered to be stable or very stable. The measurements were then repeated after continuous positive airway pressure (CPAP) treatment.ResultsThe extent of PN-evoked modulation of RRI was enhanced in nonrapid eye movement (NREM) sleep, though the stability was reduced in both NREM and rapid eye movement (REM) sleep. These peculiar behaviors of PN function were reversed by CPAP treatment.ConclusionWe found that instantaneous time–frequency analysis allowed estimation of transitional changes in PN function during sleep in OSA patients. 相似文献
4.
Sinha S Brady M Scott CA Walker MC 《Journal of neurology, neurosurgery, and psychiatry》2006,77(9):1076-1078
Aim
To determine the effects of sleep and wakefulness on seizures in patients with refractory epilepsy recorded while undergoing video‐electroencephalography (EEG) telemetry.Methods
The video‐EEG data of patients who had two or more seizures during video‐EEG telemetry (n = 270) were reviewed. Fifty seven patients who had seizures both in wakefulness and sleep were identified. The video and ictal EEG data were reviewed, paying specific attention to type of seizures, duration, semiology, lateralisation and number of seizures.Results
Three hundred and sixty two seizures were recorded; 237 seizures while awake and 125 while sleeping. Secondary generalisation occurred more often in sleep than in wakefulness (p<0.01). Overall, there was no significant effect of sleep on the duration of seizures or ictal EEG change. Sleep and awake seizures differed in only eight patients.Conclusion
Secondary generalisation occurred more often in sleep than in wakefulness, perhaps due to the facilitated spread of seizures during sleep. For the most part, however, seizures recorded during sleep did not differ from those recorded during wakefulness.The interaction between sleep and epilepsy has been recognised as far back as Hippocrates. Recent research has further elucidated this complex relationship. Epilepsy and epileptic drugs can have a profound effect on the sleep–wake cycle and sleep architecture. In addition, sleep can affect seizure occurrence, threshold and spread. Interictal electroencephalography (EEG) abnormalities are often potentiated during sleep, suggesting a change in seizure threshold.1,2,3,4,5 The sleep–epilepsy relationship varies, however, according to the epilepsy syndrome; in some, such as the frontal lobe epilepsies, sleep may facilitate seizures,6 whereas in others, sleep may protect against epilepsy. The finding that frontal lobe seizures have a greater chance of occurring during sleep whereas temporal lobe seizures are more likely to occur during wakefulness implies that sleep has distinct effects on seizure threshold in different brain regions.6 Furthermore, sleep can influence the extent of seizure spread, such that seizures in temporal lobe epilepsy are more likely to secondarily generalise during sleep than during wakefulness.6,7 These observations suggest that sleep may influence the pattern and extent of seizure spread, and therefore the electroclinical characteristics of the seizures. If true, this has critical implications for presurgical assessment, because seizures recorded during the day may yield different information from those recorded during the night. There have, however, been few studies on the influence of time of day on seizure semiology beyond the observation of the increased likelihood of secondary generalisation. The aim of this study was to determine retrospectively the effects of sleep and wakefulness on seizures in individual patients with refractory epilepsy undergoing presurgical assessment in a video‐EEG telemetry unit. 相似文献5.
《Journal of clinical neuroscience》2014,21(12):2112-2117
Sleep length and architecture are potential markers of progressive cognitive impairment, while neuropsychiatric symptoms and APOE4− haplotypes have been associated with more sleep complaints in patients with dementia due to Alzheimer’s disease (AD). In this cross-sectional study, we sought to investigate which factors might be related to sleep satisfaction in patients with AD. A total of 217 consecutive patients with AD were assessed for demographic features, neuropsychiatric symptoms, cognitive decline, functional impairment for activities of daily living, caregiver burden, APOE haplotypes, self-reported sleep satisfaction and length of sleep. Statistical comparisons were conducted with significance at p < 0.05. Concerning sleep complaints, 179 patients (82.5%) reported satisfactory sleep, while 38 (17.5%) were unsatisfied, with no relation to age, sex, APOE haplotypes, obesity, education, marital status, alcohol consumption or smoking found. Length of sleep (p = 0.011) and behavioural symptoms (p = 0.009) had significant associations with sleep satisfaction. Length of sleep was positively correlated with apathy (p = 0.014) and scores on the Clock Drawing Test (p = 0.015), and inversely correlated with anxiety (p = 0.015) and independence for instrumental activities of daily living (p = 0.003). Patients who were treated with memantine (p = 0.02) or anti-psychotics (p < 0.01) had longer duration of sleep. In conclusion, behavioural symptoms had strong associations with sleep satisfaction, which is highly correlated with length of sleep in patients with AD. Functional independence, apathy, anxiety, use of memantine or anti-psychotics, and scores on the Clock Drawing Test were significantly associated with length of sleep in this sample. 相似文献
6.
7.
ObjectivesRapid eye movement sleep behavior disorder (RBD) occurs idiopathically (iRBD), frequently representing a prodromal phase of Parkinson’s disease (PD). Previous reports have described that patients with PD have premorbid personality profiles such as industriousness, inflexibility, cautiousness, and lack of novelty seeking. As well, psychological stress often aggravates RBD symptoms. These phenomena encouraged us to investigate personality profiles in iRBD patients.MethodsIn this study, 53 patients with iRBD and 49 age and sex-matched healthy controls (HC) were enrolled. We used the revised version of the NEO Personality Inventory (NEO-PIR) to measure the personality of these subjects, and the 5 domains and the 30 facets of the NEO-PIR were compared between the two groups. Within the iRBD group, we investigated the association between RBD variables, e.g. the proportion of REM sleep without atonia (RWA/REM), length of RBD morbidity, frequency of vocalization or abnormal behavior, and the variables of NEO-PIR.ResultsIn the patients, olfactory function was significantly lower than that of healthy controls, but the inventory differences were not significant. The inventory showed no association with any RBD variable, or the existence of aggravation of these symptoms triggered by psychological stress, or olfactory dysfunction.ConclusionThese results suggest that RBD patients do not have a personality profile that might predict PD development. The personality profile itself cannot explain the psychological-stress-dependent aggravation of RBD symptoms. 相似文献
8.
Juan Gao Yan Li Yafei Sun Weihua Hu Yuanyuan Liu Di An 《The International journal of neuroscience》2016,126(10):893-898
In this study, we explore the sleep disorders and its associated factors in patients with Guillain–Barré syndrome (GBS), so as to work out appropriate interventions to promote early recovery of the patients. This study subjects included 49 patients with GBS who had been admitted to the Department of Neurology at The Affiliated Hospital of Hebei University, fulfilling National Institute of Neurological and Communicative Diseases and Stroke (NINCDS) criteria for GBS; 37 cases were male and 12 female (age: 27–68 years). Patients were evaluated once daily for two consecutive weeks. By using Wong and Baker Face Scale (WBFS) to evaluate the numbness and pain in patients, 0 points representing completely no pain and 10 points represents the most severity of the pain reactions; the same applies for numbness. The GBS Disability Scale (GBS DS) is used to evaluate the severity of GBS. The Hospital Anxiety and Depression Scale (HADS) is used to evaluate the anxiety and depression the patient is experiencing. All patients take routine EMG and sleep EEG. The sleep quality of the subjects was evaluated by the Pittsburgh Sleep Quality Index Scale (PSQI) and Richard Campbell Sleep Rating Scale. This study found that the application of ventilators, numbness, anxiety and severe limb movement disorders are the main factors causing sleep disorders. Cerebrospinal fluid (CSF) protein concentration is also associated with sleep disorders. But, no obvious abnormalities were found in sleep EEG. The application of the ventilator, numbness, anxiety and severe limb movement disorder are main factors causing sleep disorders. CSF protein concentration is also associated with sleep disorders. 相似文献
9.
We analyzed 136 patients (age, 67.5 ± 6.9 years; men, 59.6%) with idiopathic rapid eye movement sleep behavior disorder (iRBD). The results of the neuropsychological tests were not significantly different between APOE ε4 carriers and noncarriers, suggesting that the APOE ε4 allele was not associated with cognitive impairment in iRBD. 相似文献
10.
11.
Background
Hypercortisolism as a sign of hypothamamus-pituitary-adrenocortical (HPA) axis overactivity and sleep EEG changes are frequently observed in depression. Closely related to the HPA axis is the renin-angiotensin-aldosterone system (RAAS) as 1. adrenocorticotropic hormone (ACTH) is a common stimulus for cortisol and aldosterone, 2. cortisol release is suppressed by mineralocorticoid receptor (MR) agonists 3. angiotensin II (ATII) releases CRH and vasopressin from the hypothalamus. Furthermore renin and aldosterone secretion are synchronized to the rapid eyed movement (REM)-nonREM cycle. 相似文献12.
13.
14.
Sleep apnoea is a condition in which people stop breathing during sleep. A number of studies in general and worker populations have shown that the prevalence of an apnoea-hypopnoea index (AHI) >10 is in the range of 20%. Subjects with an AHI >10 that complain of excessive daytime somnolence, tiredness, asphyxic episodes during the night or non-refreshing sleep, among other symptoms, suffer from the sleep apnoea hypopnoea syndrome (SAHS). The prevalence of SAHS is around 4%. Owing to its high prevalence, clinical symptoms, probable secondary cardiovascular consequences and associated social problems, SAHS has a considerable impact on health, management of which is worth considering. Despite the fact that SAHS treatment has been challenged recent studies conclude that nasal continuous positive airway pressure (nCPAP) is undoubtedly effective in clearly symptomatic patients. Its use in clinical practice is adequately supported in the treatment of moderate to severe SAHS. Further studies are needed in order to define the lower range of symptoms to be treated. One of the most important problems encountered in this area results from the combination of two situations. On the one hand, different epidemiological studies have demonstrated that an AHI >10 without symptoms is present in around 15% of the general population. On the other hand, several studies suggest that having a high AHI, even without secondary symptoms, gives rise to some undesirable effects such as traffic accidents and cardiovascular consequences. In this context, comprehensive epidemiological studies are therefore warranted to define the role of nCPAP treatment especially in those subjects with a high AHI but with few or no symptoms. 相似文献
15.
Montanaro Elisa Romagnolo Alberto Fabbri Margherita Artusi Carlo Alberto Imbalzano Gabriele Rizzone Mario Giorgio Lopiano Leonardo Zibetti Maurizio 《Journal of neurology》2022,269(3):1538-1545
Journal of Neurology - Parkinson’s disease (PD) is increasingly recognized as a multidimensional disorder, characterized by several non-motor symptoms, including disturbances of sleep and... 相似文献
16.
Nihei Y Takahashi K Koto A Mihara B Morita Y Isozumi K Ohta K Muramatsu K Gotoh J Yamaguchi K Tomita Y Sato H Seki M Iwasawa S Suzuki N 《Journal of neurology》2012,259(8):1606-1612
REM sleep behavior disorder (RBD) is known to be observed more frequently in patients with an α-synucleinopathy such as Parkinson's disease (PD) than in the general population. The precise prevalence of RBD in Japanese PD patients is not known. Therefore, we investigated the prevalence and the clinical characteristics of patients with RBD in a large population of Japanese patients with PD. We investigated various clinical features and employed the Japanese version of the RBD screening questionnaire on 469 non-demented Japanese PD patients in this multicenter study. Probable or possible RBD was detected in 146 patients (31.1%) and was significantly associated with longer PD duration, higher Hoehn and Yahr stage, higher Unified Parkinson's Disease Rating Scale part III subscale (7 items), more motor fluctuations, and a higher levodopa-equivalent daily dose (p < 0.01). As to the major autonomic dysfunctions, severe constipation was significantly more frequent in PD patients with RBD than in those without it (p < 0.01). The RBD symptoms of 53 patients (39.0%) preceded the onset of PD motor symptoms. The median interval from the onset of RBD symptoms to PD motor symptoms was 17.5 years, and 3 patients had intervals of over 50 years. This large-scale multicenter study revealed that RBD is a frequent non-motor symptom in Japanese patients with PD, which may precede the onset of motor symptoms. Moreover, RBD that increases with the duration and severity of PD may be associated with autonomic dysfunction. 相似文献
17.
Santiago Perez-Lloret Malco Rossi María Inés Nouzeilles Claudia Trenkwalder Daniel P. Cardinali Marcelo Merello 《Journal of neurology》2009,256(9):1480-1484
The aim of this study was to compare the results of the day-to-day self-evaluation of sleep quality by sleep logs with Parkinson’s disease sleep scale (PDSS) in Parkinson’s disease (PD) patients. Actigraphy was used as an independent analysis of nighttime activity interfering with sleep. A total of 71 idiopathic PD patients and 21 age- and sex-matched normal individuals lacking any type of sleep disturbance were recruited. Sleep was evaluated by PDSS, 7-d sleep log and actigraphy. Sleep logs and PDSS showed reduced sleep quality and daytime somnolence scores in moderate/severe PD patients as compared to healthy controls. Significant correlations were found between sleep quality in sleep logs and all domains of PDSS sleep quality, except for the presence of nocturia, which correlated with nocturnal activity. PD severity and depression were the only predictors of reduced sleep quality. The retrospective and day-to-day sleep self-evaluations were coincident. Reduced sleep quality was related to increased PD severity and depression scores. 相似文献
18.
Obstructive sleep apnoea (OSA) is a common condition. Whether an apnoeic patient should be considered for treatment depends on the definition of the syndrome, the rating of the severity and the potential morbidity associated with this condition. We have reviewed several types of evidence that early treatments of OSA deserved. There is a natural evolution of OSA leading to spontaneous aggravation and an increased cardiovascular morbidity in untreated patients in clinical populations. Excessive daytime sleepiness (EDS), the key symptom of the disease, can be found with very low apnoea hypopnoea index (AHI) and eliminated by adequate treatment. Cardiovascular risks are present with very low AHI and there is a high relative risk of developing hypertension in the future when patients present with mild OSA at baseline. The effect of treatment is significant when compared with placebo in the mildest forms of the disease. The clinical benefit, however, is mainly expected in terms of consequences for behavioural morbidity (i.e. reversibility of EDS and its related consequences) as the impact on cardiovascular morbidity is more doubtful and may anyway not be observed on a short-term follow-up. Overall, any OSA syndrome that is clearly responsible for EDS should be considered for treatment. Moreover, there is increasing evidence that the cardiovascular risk has to be taken into account when deciding on treatment, even in asymptomatic patients. All this evidence put together suggests early treatment in OSA. 相似文献
19.
《Sleep medicine》2020
BackgroundRapid eye movement (REM) sleep behavior disorder (RBD) is a male-predominant parasomnia. Earlier clinical RBD patient studies showed gender differences of clinical symptoms and polysomnographic (PSG) findings. However, no previous investigated this issue by means of validated severity scales or by neuropsychological examination related to alpha-synucleinopathy. This study elucidates gender differences in clinical, physiological, and neuropsychological findings in Japanese idiopathic RBD (iRBD) patients.MethodsFrom 220 patients with complaint of sleep-related vocalization or behaviors who visited Yoyogi Sleep Disorder Center from June 2003 through December 2016, 43 female (68.7 ± 7.3 yr) and 141 male patients (66.7 ± 6.7 yr) diagnosed as having iRBD by video-polysomnography (v-PSG) were selected. All subjects answered the RBD questionnaire (RBDQ-JP) and underwent olfactory function test (Sniffin' Sticks test) and cognitive function test (MoCA-J).ResultsFemale iRBD patients had later first symptom-witnessed age (sleep-talking 63.2 ± 10.5 yr, behaviors 60.9 ± 8.6 yr) than male patients (sleep-talking 59.1 ± 8.8 yr, behaviors 64.7 ± 8.9 yr). No gender difference was found in age at diagnosis, clinical severity (RBDQ-JP), or olfactory or cognitive function. Regarding electromyogram (EMG) findings during REM sleep, phasic EMG activity was higher in female patients (22.3 ± 17.8% vs. 16.5 ± 16.1%), although no difference was found in tonic EMG activity.ConclusionsAlthough female iRBD patient symptoms were first recognized later than those of male patients, they showed elevated EMG activity during REM sleep and showed deteriorated olfactory and cognitive function similarly to male patients at the first medical consultation. Results suggest that disease progression in female RBD patients is equivalent to that in male patients. 相似文献
20.
Does obstructive sleep apnea confound sleep architecture findings in subjects with depressive symptoms? 总被引:5,自引:0,他引:5
BACKGROUND: Compared with normal subjects, depressed patients have shorter rapid eye movement sleep latency (REML), increased REM and decreased slow wave sleep as a percentage of total sleep time (REM%, SWS%), and longer sleep latency (SL). Obstructive sleep apnea (OSA) patients experience longer REML, decreased REM% and SWS%, and shorter SL. We examined the interplay of depressive symptoms, OSA, and sleep architecture. METHODS: Subjects (n = 106) were studied with polysomnography. OSA was defined as a Respiratory Disturbance Index > or = 15. Subjects were divided into Hi/Lo groups using a Center for Epidemiological Studies-Depression (CES-D) score of 16. RESULTS: OSA patients had shorter SL than non-OSA patients (14.5 vs. 26.8 min, p <.001); Hi CES-D subjects showed a trend toward longer SL than Lo CES-D subjects (23.7 vs. 17.5 min, p =.079). Significant OSA x CES-D interactions emerged, however, for REM% (p =.040) and SL (p =.002): OSA/Hi CES-D subjects had higher REM% than OSA/Lo CES-D subjects (19.3% vs. 14.3%, p =.021); non-OSA/Hi CES-D subjects had SL (35.3 min) 2-3 times as long as other subjects (p =.002-.012). CONCLUSIONS: Because of the high prevalence of OSA and depression, findings suggest that OSA must be considered in studies of mood and sleep architecture. Conversely, depressive symptoms must be considered in studies of OSA and sleep architecture. 相似文献