慢眼动潜伏期对阻塞性睡眠呼吸暂停低通气综合征患者嗜睡评估的价值

Slow eye movement analysis in patients with obstructive sleep apnea/hypopnea syndrome

目的 探索慢眼动潜伏期对OSAHS患者嗜睡评估的价值.方法 连续入选201 1年9月至11月在北京协和医院睡眠呼吸疾患诊疗中心进行整晚多导睡眠监测并确诊为重度OSAHS的男性患者20例,平均年龄为（41±9）岁,平均体重指数为（31±4）kg/m2.分别进行多次睡眠潜伏期试验（MSLT）和清醒维持试验（MWT）,经人工睡眠分期及慢眼动分析后,得出慢眼动潜伏期及睡眠潜伏期（SL）,应用统计学方法进行一致性及相关性分析.每位患者应用Epworth嗜睡量表进行主观嗜睡的评估.结果 MSLT和MWT中平均慢眼动潜伏期均短于平均SL.MSLT的平均慢眼动潜伏期与平均SL分别为（4.2±1.9） min和（5.3±2.0） min,MWT的平均慢眼动潜伏期与平均SL分别为（12±10） min和（13±10） min.MSLT及MWT的平均慢眼动潜伏期与平均SL均呈正相关（r=0.958,0.997,均P＜0.001）；20例患者中18例Epworth嗜睡量表评分≥11分.MSLT中19例平均慢眼动潜伏时间≤8 min；MWT中9例平均慢眼动潜伏时间≤8 min.ESS评分与MSLT平均慢眼动潜伏期呈负相关,而在MWT中,两者未发现明显相关性.结论 慢眼动潜伏期短于SL,两者呈明显正相关,慢眼动潜伏期是进行嗜睡评价的良好指标.

Objective To determine whether slow eye movement （SEM） analysis performed comparably to standard sleep onset criteria at the multiple sleep latency test （MSLT） and the maintenance of wakefulness test （MWT） in patients with obstructive sleep apnea/hyponea syndrome （OSAHS）.Methods We compared SEM latencies with sleep latencies upon analysis of MSLT and MWT recordings artificially,in a population of 20 severe OSAHS patients that randomly underwent the 2 tests 2 days apart.They all answered the Epworth Sleepiness Scale.Results Mean SEM latency was different from standard sleep onset in the MSLT [（4.2±1.9） min vs （5.3±2.0） min,P〈0.001],and the MWT [（12±10） min vs （13± 10） min,P 〈0.001].Mean SEM latency correlated significantly with the sleep latency at the MSLT （r =0.958,P 〈 0.001） and at the MWT （r =0.997,P 〈 0.001）.Finally,the Epworth Sleepiness Scale score correlated with SEM latency at the MSLT （r =-0.580,P =0.007）,but not at the MWT.Conclusions SEM latency was different from sleep latency that detected from EEG,but they correlated significantly with each other,thus providing a simplified way to evaluate sleepiness.