矛盾性失眠患者循环交替模式分析

Analysis of cyclic alternating pattern in patients with paradoxical insomnia

目的探讨矛盾性失眠(Par I)患者的睡眠微结构特征。方法根据多导睡眠呼吸监测(PSG)结果和患者当晚主观睡眠时间之间差异纳入Par I患者28例(Par I组)和原发性失眠(PI)患者30例(PI组),并纳入健康对照10名(对照组),均对其进行匹兹堡睡眠质量指数量表(PSQI)评估和循环交替模式(CAP)分析。结果Par I组和PI组PSQI总分及除睡眠药物使用因子外其他因子分均高于对照组(P<0.05)。在PSG参数上,Par I组睡眠总时间(TST)、快速眼动睡眠相(REM)时间高于PI组(P<0.05);PI组的睡眠效率低于对照组(P<0.05)。在CAP参数上,Par I组和PI组CAP总时间、CAP与非快眼动睡眠(NREM)百分比(CAP/NREM)、CAP与TST百分比(CAP/TST)、S2CAP时间、S2CAP率及A1百分比均高于对照组(P<0.05)。结论矛盾性失眠患者的睡眠稳定性差,连续性差。

Objective To explore the sleep microstructural characteristics in patients with paradoxical insomnia(Par I).Methods A total of 28 patients with Par I in Par I group and 30 patients with primary insomnia(PI)in PI group were selected and divided according to the differences of Polysomnography(PSG)results and subjective sleep quality.There were also 10 healthy controls included in control group.They were all assessed with Pittsburgh Sleep Quality Index(PSQI)and Cyclic Alternating Pattern(CAP).Results The total scores and all factor scores except the sleep medication factor score of PSQI in Par I group and PI group were all significantly higher than those in control group(P<0.05).In terms of PSG parameters,total sleep time(TST)and REM duration in Par I group were significantly higher than those in PI group(P<0.05),and the sleep efficiency of PI group was significantly lower than that in control group(P<0.05).The total time of CAP,CAP/NREM,CAP/TST,S2CAP time,S2CAP rate and A1 percent in PI group and Par I group were all significantly higher than those in control group(P<0.05).Conclusion The stability and continuity of sleep in patients with Par I are poor.