抑郁症自杀倾向与多导睡眠图的关系

目的：探讨抑郁症患者自杀倾向与多导睡眠图之间的关系。方法：对16例有明显自杀观念或自杀行为的抑郁症患者（自杀组）、20例无自杀观念或自杀行为的抑郁症患者（非自杀组）、20例正常对照者检测多导睡眠图,并进行睡眠参数比较。结果：①抑郁症自杀组与非自杀组均存在诸多睡眠指标的异常,包括睡眠总时间减少、慢波睡眠百分比降低、睡眠效率和睡眠维持率降低、觉醒时间和觉醒次数增加、觉睡比和睡眠阶段s1百分比增加、REM睡眠潜伏期缩短以及REM密度增加。②自杀组与非自杀组相比,前者在睡眠进程方面表现为更加频繁的觉醒、更长的觉醒时间、更高的觉睡比以及更低的睡眠维持率,在REM睡眠方面,前者表现为更加严重的REM睡眠脱抑制,如REM睡眠潜伏期更短、整夜REM睡眠时间更长,整夜及第一个REM睡眠百分比更高、REM活动度和强度更高。结论：抑郁症的睡眠维持障碍和REM睡眠紊乱与其自杀倾向可能具有密切联系,表现为频繁的觉醒、REMM睡眠潜伏期缩短、REM活动度和强度增加以及REM睡眠时间延长的抑郁症患者可能预示更高的自杀风险。     

脑卒中后抑郁状态与抑郁症患者的多导睡眠图对照研究

目的：探讨脑卒中后抑郁状态（PSD）患的睡眠图异常改变及与抑郁症之间的差异。方法：采用多导睡眠图对62例脑卒中和30例抑郁症患进行整夜睡眠描记，并与对照组比较。结果：PSD组与对照组和非抑郁组比较多项睡眠指标均有显性差异（P＜0．05－0．01）；PSD组的REM睡眠时间和密度明显低于抑郁症组，差异有显性（P＜0．01）。结论：PSD状态病人除具有睡眠障碍在多导睡眠图改变外，REM睡眠时间和密度是一个较为特征性的改变，PSD的发生可能与脑内5－羟色胺（5－TH）递质改变有关。     

抑郁症患者REM睡眠脑电图的研究

目的 探讨抑郁症患者睡眠脑电图的特点。方法 对50例抑郁症患者和50例正常对照者进行睡眠脑电图检测，并进行对照。结果 抑郁症患者REM睡眠密度增加、潜伏期缩短、时间缩短、周期减少。结论 抑郁症患者睡眠脑电图中的REM指标，可作为抑郁症临床诊断的参考指标。     

脑卒中后抑郁患者的睡眠脑电图研究

目的：探讨脑卒中后抑郁状态患者的睡眠脑电图异常改变及与抑郁症患者之间的差异。方法：采用多导睡眠图对32例脑卒中抑郁患者和30例抑郁症患者进行睡眠描记，并与对照组比较。结果：PSD组的REM睡眠时间和密度明显低于抑郁症组，差异有显著性。结论：PSD患者REM睡眠时间和密度是一个较为特征性的改变，提示卒中后抑郁的发生可能与脑内5-羟色胺递质改变有关。     

脑卒中后抑郁状态与抑郁症患者的多导睡眠图对照研究

目的探讨脑卒中后抑郁状态(PSD)患者的睡眠图异常改变及与抑郁症之间的差异。方法采用多导睡眠图对62例脑卒中和30例抑郁症患者进行整夜睡眠描记,并与对照组比较。结果PSD组与对照组和非抑郁组比较多项睡眠指标均有显著性差异(P<0.05～0.01);PSD组的REM睡眠时间和密度明显低于抑郁症组,差异有显著性(P<0.01)。结论PSD状态病人除具有睡眠障碍在多导睡眠图改变外,REM睡眠时间和密度是一个较为特征性的改变,PSD的发生可能与脑内5-羟色胺(5-TH)递质改变有关。     

多道睡眠图指标评估脑卒中后抑郁的价值

目的：探讨多道睡眠图(polysomnograph，PSG)指标对脑卒中后抑郁(post-stroke depression，PSD)的诊断价值。方法：30例研究对象分为3组进行多道睡眠图检查并分析其结果：病例组为10例PSD患者，根据DSM-Ⅳ诊断标准确诊；对照组为10例脑卒中后无抑郁的患者；正常组为年龄、性别匹配的健康者。结果：与对照组、正常组比较，病例组睡眠结构发生明显变化，表现为睡眠潜伏期延长，快速动眼睡眠与非快速动眼睡眠(REM-NREM)周期次数增加；快速动眼睡眠(rapid eye movements，REM)潜伏期缩短；REM活动度、强度、密度增加；S1阶段睡眠增加，S2和S3 4阶段睡眠减少。总睡眠时间、慢波睡眠时间比正常组少，但与对照组之间无差异；3组之间觉醒时间、睡眠效率无明显差异。结论：PSD患者存在PSG指标变化，这些改变可能有助于PSD的诊断参考。     

脑梗死恢复期患者的多道睡眠图评价

目的 探讨脑梗死恢复期患者睡眠参数改变的生物学特点。方法 应用多道睡眠图对36例脑梗死恢复期患者进行睡眠描记，分析相关睡眠参数，并与20例正常人比较。结果 脑梗死恢复期患者睡眠伏期延长（38.44min）、总睡眠时间减少（259.71min）、中途醒转次数增多(7.55次）、睡眠效率低（58.06%)、眼动（REM）睡眠潜伏期缩短（62.36min）、REM睡眠时间（32.42min）和REM活动度（67.91单位）减少（P＜0.05-0.01)。结论 脑梗死恢复期患者不但有睡眠量的减少，而且伴有睡眠质的改变，其中REM睡眠潜伏期、REM睡眠时间和REM活动度是评价脑功能恢复的客观指标。     

抑郁症患者睡眠生理的特征改变

目的：探讨抑郁症患者睡眠生理结构的变化，并与正常人比较。方法：抑郁症组为2002—01／2004—12广州市精神病医院门诊抑郁症患者42例，正常对照组为广州市精神病医院部分职工和广州医学院部分学生，共选择30人。使用英国Oxford工厂生产的Medilog多导睡眠图记录仪进行多导睡眠图检查．记录整夜的脑电图信号。主要观察①睡眠进程：包括总记录时间，睡眠总时间．睡眠潜伏期，快速眼动睡眠潜伏等。②睡眠结构：包括各阶段（非快速眼动S1、S2、S3、S4、快速眼动）睡眠的时间和百分比，快速眼动活动度、密度和强度，睡后觉醒的次数、时间和百分比。③睡眠片断的平均时程。对此项检查获患者及家属全面知情同意。结果：抑郁症组及正常对照组均完成多导睡眠图的检查，全部进入结果分析。①睡眠进程分析：总记录时间两组无差异，抑郁症组睡眠总时间比正常对照组少，睡眠潜伏期比正常对照组长，快速眼动睡眠潜伏期比正常对照组短，差异均有显著性（P〈0．05），抑郁症组睡眠效率和维持率低。②睡眠结构分析：抑郁症组非快速眼动S1时间比正常对照组长，但无统计学意义；非快速眼动S2时间比正常对照组短，[（212．72&;#177;92．9），（224．63&;#177;8．1）min，F=9．388，P=-0．004]；而非快速眼动（S3＋S4）时间比正常组短，但无统计学意义，不少患者的整个慢波睡眠（S3＋S4）缺失。抑郁症组快速眼动活动度、密度和强度均显著高于正常对照组，睡后觉醒时间长。（爹抑郁症组睡眠片断的平均时程低于正常对照组[（81.90&;#177;7．2），（96.73&;#177;8．6）min，P=0．818]。结论：抑郁症组睡眠潜伏期长、睡后觉醒时间长，睡眠效率和维持率低，快速眼动潜伏期缩短，S1睡眠延长，S3，S4睡眠缩短，部分患者的整个慢波睡眠（S3＋S4）缺失。提示抑郁症患者与正常人有不同的睡眠模式，其睡眠障碍模式以快速眼动睡眠过度活跃为特征。     

多道睡眠图指标评估脑卒中后抑郁的价值

目的探讨多道睡眠图 ( polysomnograph,PSG)指标对脑卒中后抑郁 (post-stroke depression,PSD)的诊断价值. 方法 30例研究对象分为 3组进行多道睡眠图检查并分析其结果病例组为 10例 PSD患者,根据 DSM-Ⅳ诊断标准确诊;对照组为 10例脑卒中后无抑郁的患者;正常组为年龄、性别匹配的健康者. 结果与对照组、正常组比较,病例组睡眠结构发生明显变化,表现为睡眠潜伏期延长,快速动眼睡眠与非快速动眼睡眠( REM-NREM)周期次数增加;快速动眼睡眠( rapid eye movements,REM)潜伏期缩短; REM活动度、强度、密度增加; S1阶段睡眠增加, S2和 S3+ 4阶段睡眠减少.总睡眠时间、慢波睡眠时间比正常组少,但与对照组之间无差异. 3组之间觉醒时间、睡眠效率无明显差异. 结论 PSD患者存在 PSG指标变化,这些改变可能有助于 PSD的诊断参考.     

喹硫平对精神分裂症患者睡眠脑电活动影响的研究

目的 应用多导睡眠图探讨喹硫平对精神分裂症患者睡眠过程中脑电活动的影响.方法 将40例精神分裂症患者和40例既往睡眠质量良好的志愿者分为研究组和正常对照组,研究组于第2、3天给予喹硫平片100 mg口服.两组研究对象于第1、2、3天连续进行多导睡眠图分析,观察多导睡眠图的变化.结果 研究组服用喹硫平后睡眠进程和睡眠总时间有所改善,觉醒次数减少,S1周期缩短,S2和慢波睡眠（S3、S4）增加,而REM时间和潜伏期无见明显变化.结论 喹硫平能增加睡眠总时间,改善患者睡眠的质量.     

不宁腿综合征多导睡眠图监测情况分析

目的探讨不宁腿综合征（restless legs syndrome,RLS）夜间视频多导睡眠图与患者睡眠质量主观感受的差异,分析RLS患者伴发焦虑-抑郁状态。方法 26例RLS患者为RLS组,24例体检健康者为对照组,分析2组视频多导睡眠图结果,应用汉密尔顿焦虑抑郁量表及匹兹堡睡眠质量问卷评价RLS患者的焦虑-抑郁状态及主观睡眠情况。结果与对照组比较,RLS组总睡眠时间、睡眠效率、睡眠维持率、快速眼动睡眠次数降低（P〈0.05）,睡眠潜伏期、快速眼动睡眠潜伏期、醒起时间、≥5min的醒觉次数、非快速眼动睡眠Ⅰ期和Ⅱ期所占睡眠比例延长或增高（P〈0.05）。结论多导睡眠监测可客观评定患者睡眠质量,对RLS诊断有一定价值。     

State of vigilance,oestrogen replacement therapy,and lipid profile as modifiers of nocturnal movement-induced heart rate responses

Study objectives: To investigate the body movement‐associated heart rate responses during sleep in postmenopausal women and to evaluate the possible effect of transdermal oestrogen replacement therapy and metabolic factors on these responses. Design: A prospective double‐blind cross‐over placebo‐controlled trial. Setting: A university sleep research unit. Patients: Seventy‐one healthy postmenopausal women. Methods: The subjects underwent a whole‐night polysomnography including an electrocardiogram (ECG) and a sensitive whole‐body movement sensor channel. Body movements of 2–15 s duration with an artefact‐free ECG were identified and heart rate was automatically analysed for 30 s before and 60 s after movement. The movement‐induced reflex tachycardia and the following rebound bradycardia were measured for the awake state, non‐rapid eye movement (REM) sleep and REM sleep. Indices of the heart rate response correlated with age, body mass index (BMI) and high‐density lipoprotein (HDL)/low‐density lipoprotein (LDL) cholesterol ratio. Results: The tachycardia response to a body movement was stronger during sleep than in the awake state, being strongest in REM sleep. The rebound bradycardia following a tachycardia response was relatively similar in REM and in the awake states, but attenuated in non‐REM sleep. Oestrogen did not influence the heart rate response. Increasing age and BMI attenuated the response, while an increase in the HDL/LDL cholesterol ratio enhanced the rebound bradycardia response. Conclusions: Sleep powerfully modulates the rapid cardiac autonomic responses to internal stressors. Postmenopausal hormone replacement therapy does not influence these responses, but they are strongly modulated by lipid metabolism and closely correlated with age and BMI.     

发作性睡病5例临床特征分析

[目的]探讨发作性睡病的临床特征.[方法]对本院5例发作性睡病患者的临床资料进行回顾性分析.[结果]5例患者均无明显诱因及阳性家族史,均有白天过度嗜睡,其中3例伴猝倒,2例有入睡前幻觉.首发症状为白天过度嗜睡2例,猝倒伴白天过度嗜睡3例.实验室及影像学检查均无特殊改变.5例患者均进行整夜多导睡眠图（PSG）检查及多次小睡潜伏期试验（MSLT）检查.PSG结果显示睡眠潜伏期〈10 min,快速眼动睡眠（REM）潜伏期〈20 min.MSLT结果显示所有患者平均睡眠潜伏期〈5 min,其中3例出现2次或2次以上睡眠始发REM睡眠（SOREMPs）,2例未见SOREMPs,但平均REM潜伏期〈10 min.[结论]发作性睡病是慢性神经系统疾病,PSG及MSLT检查可以明确诊断,对患者应给予长期的药物治疗,心理治疗和健康教育,以提高患者的生活质量     

Sympathetic neural mechanisms in obstructive sleep apnea.

Blood pressure, heart rate, sympathetic nerve activity, and polysomnography were recorded during wakefulness and sleep in 10 patients with obstructive sleep apnea. Measurements were also obtained after treatment with continuous positive airway pressure (CPAP) in four patients. Awake sympathetic activity was also measured in 10 age- and sex-matched control subjects and in 5 obese subjects without a history of sleep apnea. Patients with sleep apnea had high levels of nerve activity even when awake (P < 0.001). Blood pressure and sympathetic nerve activity did not fall during any stage of sleep. Mean blood pressure was 92 +/- 4.5 mmHg when awake and reached peak levels of 116 +/- 5 and 127 +/- 7 mmHg during stage II sleep (n = 10) and rapid eye movement (REM) sleep (n = 5), respectively (P < 0.001). Sympathetic activity increased during sleep (P = 0.01) especially during stage II (133 +/- 9% above wakefulness; P = 0.006) and REM (141 +/- 13%; P = 0.007). Peak sympathetic activity (measured over the last 10 s of each apneic event) increased to 299 +/- 96% during stage II sleep and to 246 +/- 36% during REM sleep (both P < 0.001). CPAP decreased sympathetic activity and blood pressure during sleep (P < 0.03). We conclude that patients with obstructive sleep apnea have high sympathetic activity when awake, with further increases in blood pressure and sympathetic activity during sleep. These increases are attenuated by treatment with CPAP.     

Episodic Cluster Headache: NREM Prevalence of Nocturnal Attacks. Time to Look Beyond Macrostructural Analysis?

(Headache 2010;50:1050‐1054) Background.— A high prevalence of nocturnal sleep‐related attacks is reported in patients with cluster headache (CH). Episodic CH is considered closely related to rapid eye movement (REM) sleep. Objective.— The aim of this study was to analyze the relationships between episodic CH attacks and sleep macrostructure. Methods.— Data were obtained by means of 24‐hour continuous ambulatory polysomnography (PSG) capturing CH attacks in 4 out of 7 episodic CH patients (all males; mean age 38.4 ± 9.2 years) studied. Results.— Eight CH attacks were captured during the PSG monitoring; 5 arose from sleep: 4 from non‐rapid eye movement (NREM) sleep (stage 2 NREM), and 1 from REM sleep. One patient experienced CH attacks during both NREM and REM sleep in the same night. Conclusions.— In the light of previous literature findings, the prevalence of NREM‐related episodic CH attacks observed, and the finding of attacks arising during both REM and NREM sleep in the same subject, suggest that the relationship between CH and sleep stages is heterogeneous, and the existence of a specific macrostructural pattern associated with episodic CH attacks appears to be uncertain. A more comprehensive approach taking into account the microstructure of NREM and REM sleep is expected to provide more in depth information about the pathophysiology of CH, whose complexity might overcome the simplistic dichotomy of REM/NREM staging.     

奥氮平对精神分裂症患者睡眠脑电活动的影响

目的：应用多导睡眠图探讨奥氮平对精神分裂症患睡眠脑电活动的影响。方法：对13例精神分裂症患连续进行3个晚上多导睡眠图检查，其中第2、3晚上睡前予10mg奥氮平，观察用药后多导睡眠图的变化。正常对照组14名，作2夜基础多导睡眠图监测。结果：精神分裂症患服用奥氮平后睡眠进程和睡眠总时间有所改善，觉醒时间减少和S1缩短，S2和慢波睡眠(S3、S4）显增加，而快速眼动(REM)时间和潜伏期未见明显变化。结论：奥氮平能增加睡眠总时间，改善睡眠质量，这可能与奥氮平拮抗5-羟色胺能神经元作用相关。     

阻塞性睡眠呼吸暂停低通气综合征患者心理状况研究

目的 分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的心理状况。方法 对经多导睡眠监测(PSG)确诊且符合纳入、排除标准的200例OSAHS患者进行SCL 90心理量表测评,并着重分析焦虑、抑郁得分与PSG指标的相关性,探讨两者之间的关系。结果 OSAHS患者整体心理状况较正常人差,其中：躯体化、强迫症状、人际关系敏感、抑郁、焦虑、恐怖、偏执、精神病性因子分较国内常模高（P<0.05）,且不同病情程度的OSAHS患者心理状况差异有统计学意义（P<0.05）。OSAHS患者焦虑、抑郁得分与呼吸暂停低通气指数(AHI)、微觉醒指数(MAI)、血氧饱和度低于90%的时间占睡眠总时间比(TS90)呈正相关（P<0.05）,与最低血氧饱和度(LSaO2)、快动眼睡眠(REM)及深睡眠时间占比呈负相关（P<0.05）。结论 OSAHS患者整体心理状况较正常人差,病情程度不同的患者心理状况也存在差异,其焦虑、抑郁得分与慢性夜间缺氧、睡眠片段化及睡眠结构紊乱有关。     

睡眠监测技术对日间过度思睡患者病因诊断的研究

目的:探讨睡眠监测技术对日间过度思睡(Excessive Daytime Sleepiness,EDS)的病因学诊断价值.方法:选取2017年6月至2019年6月安徽医科大学附属巢湖医院收治的EDS患者115例作为研究对象,行整夜多导睡眠监测及次日的多次睡眠潜伏期试验(Multiple Sleep Latency Te...