睡眠监测技术对日间过度思睡患者病因诊断的研究

Study on the Etiological Diagnosis of Excessive Daytime Sleepiness by Sleep Monitoring Technology

目的:探讨睡眠监测技术对日间过度思睡(Excessive Daytime Sleepiness,EDS)的病因学诊断价值。方法:选取2017年6月至2019年6月安徽医科大学附属巢湖医院收治的EDS患者115例作为研究对象,行整夜多导睡眠监测及次日的多次睡眠潜伏期试验(Multiple Sleep Latency Test,MSLT)。根据临床症状、多导睡眠监测及MSLT结果和各疾病诊断标准分为发作性睡病组(n=34)、思眠抑郁组(n=39)、阻塞性睡眠呼吸暂停(Obstructive Sleep Apnea,OSA)组(n=25)和特发性睡眠增多组(n=11)。结果:所有患者PSG均显示非快速眼球运动睡眠1期(N1)比例增加,N3和快速眼球运动睡眠(REM)比例减少。发作性睡病和思眠抑郁的发病年龄、大部分相关睡眠参数相似,但前者的睡眠潜伏期(Sleep Latency,SL)和REM潜伏期明显短于后者。MSLT显示发作性睡病组均见睡眠始发快速眼动睡眠(Sleep Onset REM Period,SOREMP),其他3组多数(68%)病例可见,特发性睡眠增多组仅18.2%可见。4组中发作性睡病的平均SL最短(76.7±3.7)min,SOREMP次数最多。结论:睡眠监测技术在EDS病因学诊断中具有重要价值。

Objective:To study the etiological diagnostic value of sleep monitoring techniques for excessive daytime sleepiness(EDS).Methods:One hundred and fifteen EDS patients(64 males and 51 females)from The Affiliated Chaohu Hospital of Anhui Medical University with overnight polysomnography and multiple sleep latency test(MSLT)in the next day were collected.According to the clinical features,polysomnogram and MSLT results,and diagnostic criteria,the patients were divided into narcolepsy group(34 cases),depression with EDS group(39 cases),obstructive sleep apnea(OSA)group(25 cases)and idiopathic hypersomnia group(11 cases).Results:The PSG of all patients showed that the proportion of non-rapid eye movement sleep stage(N)1 increased,while the proportion of N3 and rapid eye movement sleep(REM)decreased.The onset age and most sleep parameters in the narcolepsy group and depression with EDS groups were similar.And the sleep latency(SL)and REM latency in the former were significantly shorter than that in the latter.The MSLT showed that the sleep onset of REM period(SOREMP)was seen in all patients in the narcolepsy group,with only 18.2%in the idiopathic hypersomnia group and 68%in the other three groups.The mean SL was the shortest(76.7±3.7)min and the SOREMP frequency was the most in narcolepsy group.Conclusion:Sleep monitoring technology has important value in the etiological diagnosis of EDS.