肌萎缩侧索硬化患者睡眠呼吸障碍多导睡眠图分析

Polysomnographic analysis of Sleep-disordered breathing in amyotrophic lateral sclerosis patients

目的探讨肌萎缩侧索硬化(ALS)患者睡眠结构及睡眠障碍的特征。方法对44例ALS患者和36名健康对照者睡眠应用多导睡眠图(PSG)进行评估,分析患者组与对照组睡眠结构及特点。结果患者组睡眠指标中总睡眠时间(TST)缩短,睡眠潜伏期(SL)延长,睡眠效率(SE)下降,睡眠结构指标中2期睡眠时间、3期睡眠时间、REM期睡眠时间均明显缩短,微觉醒次数、>15秒觉醒次数增多。睡眠中呼吸事件指标中呼吸暂停低通气指数(AHI)增高,阻塞性呼吸暂停次数、低通气次数明显增多,平均血氧饱和度、最低血氧饱和度下降。结论 ALS患者存在睡眠障碍,主要是睡眠起始、睡眠维持障碍,睡眠呼吸事件存在阻塞性睡眠暂停。提示PSG对了解ALS患者睡眠结构和睡眠障碍有着重要意义。

Objective To investigate sleep structure and sleep disorders characterized of patients with amyotrophic lateral sclerosis. Methods PSG were used to analysis sleep structure and characteristics in 44 patients of amyotrophic lat- eral sclerosis and 36 healthy controls. Results Compared to the control group, in the case group sleep indicators, total sleep time （TST） shorten, sleep latency （SL） extend, sleep efficiency （SE） decrease. About sleep structure indicators, stage II sleep, stage Ill sleep and REM sleep duration decreaset micro-arousals, and awakening over 15 seconds in- crease! About sleep breathing events, AHI, times of obstructive apnea and hyperpnoea were more than the controls~ the mean oxygen saturation and the minimum oxygen saturation are lower. Conclusion Sleep starting and maintain disorders are the main sleep disorder in ALS patients. OSAH and hypopnea are the main problems in sleep breathing events. PSG has important significarce for understanding the structure of sleep and sleep disorders in ALS patients.