具有梦境展现行为的阻塞性睡眠呼吸暂停综合征的多导睡眠监测特点

Polysomnographic characteristics of obstructive sleep apnea syndrome with dream enacting behavior

目的研究具有梦境展现行为(dream enacting behavior,DEB)的阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)的视频多导睡眠监测(video-polysomnography,v PSG)特点。方法选取2012年1月1日至2013年10月31日因各种睡眠主诉就诊于首都医科大学宣武医院睡眠门诊且年龄大于18岁的患者共224人。所有受试者均行快速动眼睡眠疾病(rapid eyes movement sleep behavior disorder,RBD)香港问卷(RBD questionnaire-Hong Kong,RBDQ-HK)筛查(阈值为18/19)以及一整夜v PSG检查,并分为伪RBD(Pseudo-RBD)组、OSAS组、特发性RBD(idiopathic RBD,iRBD)组并对其睡眠参数进行分析。结果伪RBD组呼吸暂停低通气指数(apnea-hypopnea index,AHI)、非快速动眼睡眠(non-rapid eye movement,NREM)期AHI、REM期AHI及低通气指数高于OSAS对照组,基础血氧饱和度及最低血氧饱和度则低于OSAS对照组,低通气最长时间及血氧饱和度低于90%的时间比OSAS对照组长;与iRBD组相比,伪RBD组的梦境展现行为常常在各个睡眠期的呼吸相关觉醒时出现。结论具有DEB症状的OSAS多为中重度OSAS患者,并且DEB的发作时间往往发生于呼吸暂停相关觉醒时。

Objective To analyze the video-polysomnographic（ v PSG） characteristics of obstructive sleep apnea syndrome（ OSAS）with dream enacting behavior（ DEB）. Methods Totally 224 subjects were enrolled from sleep disease center of Xuanwu Hospital from2012 to 2013. All subjects were undergone by rapid eyes movement（ REM） sleep behavior disorder（ RBD） questionnaire-Hong Kong（ RBDQ-HK） at the cut-off value of 18 /19 and one night v PSG. The subjects were screened into three groups（ pseudo-RBD group = 17;OSAS group = 39; idiopathic RBD（ iRBD） group = 118） and the sleep apnea related parameters were compared between the three groups.Results Compared with OSAS group,pseudo-RBD patients had lower apnea hypopnea index（ AHI） and hypopnea index,more severity of oxygen desaturation [baseline oxygen saturation（ Sp O2） and minimum Sp O2] and longer maximum hypopnea time and 90% O2 saturation duration（ P 0. 05）. Compared with iRBD group,the abnormal behaviors displayed from arousals across the different sleep stages. Conclusion The symptoms of DEB more often occurred during respiratory-related arousals in the moderate to severe patients with OSAS.