简化多次小睡潜伏时间试验诊断嗜睡症可行性的探讨

目的:探讨简化多次小睡潜伏时间试验(MSLT)的可行性。方法:对20例正常人、25例发作性睡病及20例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病人,进行夜间多导睡眠图(PSG)及MSLT检查,并对各组的睡眠潜伏期及REM睡眠次数进行比较。结果:2次、3次平均睡眠潜伏期与5次平均睡眠潜伏期无显著性差异(P>0.05)。Kappa一致性检验均有显著意义(P<0.01)。以睡眠潜伏期≤5min诊断发作性睡病,其两次小睡的灵敏性91.67％～100％,特异性85.71％～95.24％;3次小睡的灵敏性92％～100％,特异性90.91％～100％。以REM睡眠出现2次以上诊断发作性睡病,其两次小睡的灵敏性100％,特异性67.3％～75.5％;3次小睡的灵敏性100％,特异性78.7％～88.1％。结论:简化MSLT诊断及鉴别诊断嗜睡症是可行的。用2次或3次小睡潜伏时间试验可替代5次小睡潜伏时间试验。

Simplified Multiple Sleep Latency Test for Diagnosis of the Excessive Daytime Sleepiness

Objective:To investigate the feasibility of the simplified multiple sleep latency test (MSLT) .Method:20 control subjects, 25 narcolepsy patients and 20 cases with obstructive sleep apnea/hypopnea syndrome (OSAHS) were studied,and the parameters of the polysomnography (PSG) and MSLT were analyed. Result: No difference was found in sleep latency time (SLT) between each time and the means of five times ( P > 0.05) . There was also no difference in SLT between the means of two or three times and the means of five times ( P > 0.05). If the SLT< 5 minutes was applied to the diagnosis of the narcolepsy, the sensitivity of two times sleep was 91.67% ~ 100% .If using rapid eye movement (REM)sleep>2 times as the diagnosis of the narcolepsy, the sensitivity of two times sleep was 100% , specificity 62.3% ~ 75.5% . The sensitivity of three times sleep was 100% , specificity 78.7% ~ 88.1 % .Conclusion:The simplified MSLT can be used for the diagnosis of the excessive daytime sleepiness (EDS) , two or three times sleep latency test can replace the five times sleep latency test.