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The multiple sleep latency test and the maintenance of wakefulness test were administered on the same day to 258 consecutive patients whose clinical presentation required evaluation for excessive sleepiness. While the MSLT is the standard test for assessing excessive daytime sleepiness, the MWT may have some clinical advantage over the MSLT when the assessment of daytime alertness is the primary goal. To explore further the relationship between alertness and sleepiness, we have conducted a thorough analysis of the similarities, differences, and correlations between MWT and MSLT. The results of this study show that the coefficient of correlation between MSLT and MWT (r = 0.41), although statistically significant, accounts for less than 17 percent of the variability between the two tests. Factor analysis suggests that two factors, alertness and sleepiness, account for 91 percent of all variance. Our data demonstrate that patients with diagnosable disorders of excessive somnolence may be discordant on the two tests (eg, having low sleep latency on MSLT but high sleep latency on MWT). Specifically, we found that some patients with abnormally low MSLT scores were able to stay awake when asked to do so on the MWT, and conversely, some patients who failed to stay awake when asked to do so on the MWT were unable to fall asleep quickly on the MSLT. We conclude that the MWT and MSLT measure different abilities and that the MWT may be a useful adjuvant daytime test in many clinical situations. 相似文献
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多次小睡潜伏时间试验在诊断嗜睡症的应用 总被引:3,自引:1,他引:3
目的多次小睡潜伏时间试验(MSLT)客观评价嗜睡严重程度、治疗效果及鉴别诊断。方法对12例正常人、17例发作性睡病及12例阻塞性睡眠呼吸暂停综合征(OSAS)患者进行MSLT检查。结果正常对照平均MSLT为20.1±6.7分;快速眼动睡眠(REM)0.1±0.3次。发作性睡病组平均MSLT3.1±1.9分(与正常组比较,P<0.01;与OSAS组比较,P<0.05);REM睡眠次数3.4±1.4次(与正常组比较,P<0.01;与OSAS组比较,P<0.05)。OSAS组平均MSLT5.7±3.2分,REM睡眠次数1.7±1.4。结论MSLT试验的平均睡眠潜伏时间及REM发生的次数对发作性睡病及OSAS患者的嗜睡严重程度及对发作性睡病的诊断和鉴别诊断具有临床价值 相似文献
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Background
This is the first study that aimed to look specifically at the utility of the 5th nap in the multiple sleep latency test (MSLT), a test used to assist in the diagnosis of narcolepsy.Methods
Data was retrospectively collected from the Sleep Disorders Centre of a Tertiary Hospital on patients that had a 5th nap during their MSLT from the 08th November 2011 to 12th November 2014.Results
Fifty-three patients had a 5th nap performed out of 378 MSLT studies. In 16% of cases a diagnosis of narcolepsy was given directly due to the inclusion of the 5th nap on the MSLT. Here a 5th nap allowed diagnostic criteria of mean sleep latency <8 minutes and >2 SOREMPS to be met. In 53% of cases the mean sleep latency increased due to 5th nap inclusion; the mean sleep latency of the first four naps was 5.6 vs. 6.7 after inclusion of the 5th nap.Conclusions
The 5th nap is not often performed within the MSLT studies. Our study shows that only a few patients may benefit from a 5th nap opportunity which also led to increase of the mean sleep latency at the expense of extra time, cost, labour and increased patient anxiety. 相似文献4.
Siqueira AF Harima HA Osiro K Hirai AT Gimeno SG Ferreira SR;Japanese-Brazilian Diabetes Study Group 《Arquivos brasileiros de endocrinologia e metabologia》2008,52(1):40-46
High prevalence of diabetes has been previously reported in Japanese-Brazilians. In an attempt to better estimate the cardiometabolic risk, this study evaluated lipid disorders in 1,330 Japanese-Brazilians (46% men) aged>30 years. Hypercholesterolemia was defined as serum cholesterol>240 mg/dL, hypertriglyceridemia as values>150 mg/dL and low-HDL-C as values<40 mg/dL and <50 mg/dl for men and women respectively. The prevalence of dyslipidemias was compared by the chi-square test between gender and glycemic category. Mean and Standard Deviation of lipids and lipoproteins were compared by the Student t-Test between gender. Hypertriglyceridemia was detected in 66.0% [95% CI: 63.5-68.5] of the population, being more common in men and increasing with deterioration of glucose metabolism. Mean level of triglycerides was 235.7+/-196.3 mg/dL. The prevalence of hypercholesterolemia was 24.4% [95% CI: 22.1-26.7]. Low HDL-C was observed in 17.5% [95% CI: 14.5-20.5] of men and 43.0% [95% CI: 39.4- 46.6] of women but total/HDL-cholesterol ratio was lower in women (4.23+/-0.68 vs. 4.40+/-0.73, p<0.001). In Japanese-Brazilians, hypertriglyceridemia is the commonest dyslipidemia, in agreement with the high prevalence of diabetes. Men showed a worse lipid profile than women; it was suggested that the Western diet and living habits could be deteriorating their health. 相似文献
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S Volk J Dyroff K Georgi B Pflug 《EEG-EMG Zeitschrift für Elektroenzephalographie, Elektromyographie und verwandte Gebiete》1992,23(4):210-214
The multiple sleep latency test (MSLT) has proved to be a useful diagnostical tool for patients complaining of excessive daytime sleepiness (EDS). The intention of the present study was to investigate the structure of MSLT naps and in particular sleep spindle and k-complex density in three different groups of EDS patients. MSLT was performed at 8 a.m., 10 a.m. 12 a.m., 2. p.m. and 4 p.m.. Each recording lasted 20 minutes and was not stopped even if sleep occurred before 20 min. Sleep was scored visually. Spindle and k-complex density was determined per minute of S2 sleep. Statistical analysis used ANOVA. Each of the three groups consisted of 15 patients. Diagnosis of narcolepsy, sleep apnea, of EDS due to a psychiatric disorder has been confirmed subsequently. There were 5 female and 10 male narcoleptics (mean age: 43.9 +/- 10.9 years), 2 female and 13 male obstructive sleep apnea patients (mean age: 53.9 +/- 10.9 years) and 7 female and 8 male patients complaining of EDS, in whom a psychiatric disorder was diagnosed (mean age: 38.8 +/- 13.8 years). Narcoleptics sent more than half of the recording time of 100 min asleep (52.9%). Apnea patients slept 41.3% and psychogenic EDS patients 22.7%. The proportion of sleep stages 1 and 2 in narcoleptics (S2/S1 = 1:1) was clearly different from the other two (apnea patients: S2/S1 = 4:1; psychogenic EDS patients: S2/S1 = 3:1). 18.5% of the naps contained stage REM and during the afternoon naps 0.9% of S3 in the narcoleptics. Neither REM nor S3 was observed in the others.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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We determined the prevalence of concomitant sleep disorders in patients with a primary diagnosis of obstructive sleep apnea (OSA). We retrospectively analyzed 643 patients, aged 18, with a primary diagnosis of OSA, evaluated by sleep specialists, in whom clinical and polysomnographic data were derived using standardized techniques by reviewing data from a standardized database and clinical charts. Concomitant sleep disorders were listed according to the International Classification of Sleep Disorders (American Academy of Sleep Medicine, 2000). The mean age was 48.5±13.5 years and 55% were male. Racial distributions were African–Americans 51.8% and Caucasian 47%. Indices of disordered breathing were respiratory disturbance index 32.4±30.4/h sleep and time <90% O2 saturation 44.5±81.6 min. Thirty-one percent of patients had a concomitant sleep disorder. The most common were inadequate sleep hygiene (14.5%) and periodic limb movement disorder (PLMD, 8.1%). Of patients with other sleep disorders, 66.8% had treatment initiated for these disorders. Predictors of inadequate sleep hygiene (logistic regression) were: age (each decade OR=0.678, P=0.000000), gender (for M, OR=0.536), and the presence of at least one other major system disorder (OR=2.123, P=0.0015). Predictors of PLMD were: age (each decade OR=0.794, P=0.0005), gender (for M, OR=0.433, P=0.004), and total sleep time (for each 10 min, OR=0.972, P=0.0013). We conclude that approximately one third of patients with sleep apnea have another identifiable sleep disorder, usually requiring treatment. This suggests that practitioners evaluating and treating sleep apnea ought to be prepared to deal with other sleep disorders as well. 相似文献
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Megan E. Jensen Peter G. Gibson Clare E. Collins Jodi M. Hilton Fiona Latham-Smith Lisa G. Wood 《Sleep & breathing》2013,17(1):281-287
Study objective
Sleep disturbance is reported to be more prevalent in children and adolescents with asthma than those without. However, this has not been described adequately using objective measures. The aim of this study was to objectively characterise sleep disturbance in asthmatic and non-asthmatic children and adolescents.Methods
A retrospective analysis of polysomnography recordings from children aged 5–17 years old, with (n?=?113) and without asthma (n?=?104), referred for a sleep study over the period 2005–2010 at the Paediatric Sleep Unit, John Hunter Children’s Hospital in Newcastle, NSW Australia, was carried out.Results
Polysomnographic recordings were analysed to compare sleep quality and quantity between asthmatic and non-asthmatic children. Sleep latency was significantly longer in asthmatic children compared to controls. However, this result was significant for females only (46.2 (5.6) vs 33.2 (2.7) min, p?<?0.05). Male asthmatics had significantly shorter sleep duration (425.9 (5.4) vs 441.8 (5.4) min, p?<?0.05) than male controls.Conclusions
Sleep disturbance exists in children with asthma and manifests differently in males and females. Further investigation into the clinical implication of increased sleep latency and reduced sleep duration upon daytime functioning and lifestyle behaviours in children and adolescents with asthma is warranted. 相似文献13.
Matthew T. Naughton 《Journal of thoracic disease》2015,7(8):1298-1310
Respiratory sleep disorders (RSD) occur in about 40-50% of patients with symptomatic congestive heart failure (CHF). Obstructive sleep apnea (OSA) is considered a cause of CHF, whereas central sleep apnea (CSA) is considered a response to heart failure, perhaps even compensatory. In the setting of heart failure, continuous positive airway pressure (CPAP) has a definite role in treating OSA with improvements in cardiac parameters expected. However in CSA, CPAP is an adjunctive therapy to other standard therapies directed towards the heart failure (pharmacological, device and surgical options). Whether adaptive servo controlled ventilatory support, a variant of CPAP, is beneficial is yet to be proven. Supplemental oxygen therapy should be used with caution in heart failure, in particular, by avoiding hyperoxia as indicated by SpO2 values >95%. 相似文献
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正Objective To analyze the status of sleep disorders in patients with functional gastrointestinal disease (FGID)and its relation with symptom characteristics. Methods From January to December 2014,questionnaire was carried out in FGID patients who met the Rome Ⅲ criteria 相似文献
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Sleep and Breathing - Poor sleep is common in patients with multiple sclerosis (MS). This study assessed the prevalence of poor sleep and investigated the potential impact factors that influence... 相似文献
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Kazuhiko Suzuki Hiroshi Tanaka Satoshi Kaneko Motoi Nishi Shin Teramoto Susumu Itoh Shosaku Abe 《The Journal of asthma》2003,40(3):243-250
The relation between smoking and risk of asthma has been well-examined; however little attention has been paid to the correlation between smoking and asthma symptoms. The aims of this study were to examine respiratory symptoms in asthmatics with a highly prevalent use of inhaled corticosteroid (ICS) and to assess the effects of smoking and its cessation. A cross-sectional study of pulmonologist-based 3197 asthmatics (men 45.2%, ages 20-97) was performed using a questionnaire about smoking habits, the incidence and frequency of symptoms (sputum, cough and wheezing, night symptoms, and shortness of breath), physical activity interference, and medication. Although 81.4% of the patients used ICS according to the international guideline, 14.9% had activity interference, and daily symptoms remained in 43.3%. At the time of the questionnaire, 21.6% were current and 25.1% were ex-smokers. In multiple logistic regression analysis, the factors of significance (p < 0.0001) were (1) smoking; for all four symptoms, (2) age and duration of asthma; for shortness of breath. Current smokers were at a risk of sputum (age-adjusted odds ratio 2.32 [95% confidence interval 1.73-3.11]; 2.09 [1.57-2.79]), of cough and wheezing (2.38 [1.81-3.14]; 1.78 [1.35-2.36]), of night symptoms (1.95 [1.41-2.60]; 1.47 [1.09-1.98]), and of shortness of breath (1.70 [1.26-2.28]; 1.30 [0.97-1.75]) in men and women, respectively. These ratios in ex-smokers decreased to the level similar to nonsmokers. Although 81.4% of asthmatic patients used ICS, 43.3% complained of daily respiratory symptoms, especially sputum. It is suggested that the effects of ICS on asthma symptoms may be interfered with by smoking and therefore more emphasis should be placed on cessation of smoking. 相似文献
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阻塞性睡眠呼吸暂停低通气综合征(OSAHS)可引起患者认知障碍,其发生机制主要与睡眠结构紊乱以及慢性间断性低氧血症有关,而缺氧敏感区脑组织的病理改变则可能是认知障碍产生的病理基础.初步研究表明OSAHS认知障碍表现为全面认知功能缺损,且可能与阿尔茨海默病有一定的相关性.儿童OSAHS的发病并不少见且可能影响到儿童的认知行为发育,需引起足够的重视.近年来,神经影像技术的应用拓展了认知功能的评估手段,但仍有待建立一套特异性高、操作性强的临床评价体系.早期积极治疗OSAHS可减缓认知障碍的发生,而莫达非尼等药物对改善OSAHS患者的认知障碍带来新的希望. 相似文献
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93例帕金森病患者睡眠障碍的临床特征分析 总被引:2,自引:1,他引:2
目的评价帕金森病(PD)患者睡眠质量,探讨PD患者睡眠障碍的临床特征. 方法采用匹兹堡睡眠质量指数(PQSI)、爱泼沃斯思睡量表(ESS)对93例PD患者和96例年龄、性别相匹配对照者的睡眠状况及临床特点进行评估. 结果 60例(64.5%)PD患者总体睡眠质量差,睡眠障碍的主要类型有入睡困难(49.5%)和片断睡眠(72.0%)、睡眠行为障碍[梦魇(50.5%)、尖叫(30.1%)和肢体反击性动作(22.6%)]、不宁腿综合征(RLS)(12.9%)以及日间过度思睡(EDS)(40.9%);而对照组有28例(29.2%)睡眠质量差,主要表现为入睡困难(22.9%)和片断睡眠(50.0%)以及EDS(14.6%),两组差异有统计学意义(P<0.01). 结论 PD患者总体睡眠质量差,伴发睡眠障碍较对照组常见,其临床主要表现为入睡困难和片断睡眠、睡眠行为障碍、EDS及RLS.提示了解PD患者睡眠障碍有利于PD的防治,提高患者的生活质量. 相似文献