帕金森患者的睡眠障碍

Sleep disturbances in patients with Parkinson disease

目的:探讨帕金森病患者睡眠结构紊乱与病程的长短、病情的严重程度以及用药种类的关系。方法:应用多项睡眠图描记分析技术(polysomnography),分析17例帕金森病患者的睡眠总时间、睡眠效率、睡眠潜伏期、睡眠醒觉的次数和时问。结果:睡眠效率低于80%的15例,睡眠潜伏期大于30 min者9例,睡眠中醒觉的时间大于60 min者15例。病程大于5年的患者的平均睡眠总时间(173 min)与病程小于5年者(276 min)相比显著减少,差异具有显著意义(P=0．02)。病程大于5年的患者睡眠潜伏期(72 min)较病程小于5年者的睡眠潜伏期(35 min)明显延长,呈明显的正相关(r= 0．44,P＜0．05)。H-Y分级与总睡眠时间呈负相关(r=0．49,P＜0．05),与睡眠潜伏期呈正相关(r= 0．56,P＜0．05)。服用两种以上药物者的睡眠潜伏期较用一种药物者的明显延长(P=0．02)。结论:帕金森病患者的睡眠结构存在明显异常,主要表现为睡眠总时间减少、睡眠效率减低、睡眠觉醒的时间和次数增多及睡眠潜伏期延长。帕金森病患者病程的长短与总睡眠时间成反比,病情的严重程度与睡眠时间及效率成反比,而与睡眠潜伏期及睡眠中醒觉的次数成正比,用药种类的多少与睡眠潜伏期成正比。

Objective： To investigate the relationship between sleep disturbances and disease duration disease severity as well as medical treatment in patients with Parkinson disease（PD）. Methods： Total sleep time, sleep efficiency, sleep latency and awake time are analyzed in 17 patients with PD by Polysomnography （PSG）. Results： Of 17 patients , 15 cases have sleep efficiency lower than 80%, 9 cases have sleep latency longer than 30 min, 15 cases have awake time longer than 60 min. The average total sleep time in patients whose disease duration is longer than 5 years （ 173 min ） significantly different from the patients with disease for less than 5 years （276 min ） ; the sleep latency in the former group（72 min ） is also significantly longer than the latter one （35 rain）. A positive correlation is observed（r=0.44, P〈 0.05） ;There is a negative correlation （r=0.49, P〈0.05）between the degree of H-Y and total sleep time, and a positive correlation （r=0.56, P〈0.05）between the degree of H-Y and sleep latency. Sleep latency in patients treated with more than two kinds of drugs is longer than those with monotherapy（P= 0.02）. Conclusions： Obvious abnormal sleep architecture is present in patients with PD, mainly reflected with shorter total sleep time, lower sleep efficiency, increased awake time and sleep latency. Disease duration is negatively correlated with total sleep time; disease severity is negatively correlated with total sleep time and sleep efficiency , but positively correlated with sleep latency and awake frequency. There is also a Positive correlation between the types of drugs applied and sleep latency.