肌萎缩侧索硬化患者的睡眠分析

Sleep analysis in patients with amyotrophic lateral sclerosis

目的探讨肌萎缩侧索硬化(Amyotrophic lateral sclerosis,ALS)的睡眠障碍患病率、睡眠质量与ALS功能评分的各重要功能域的相关性。方法收集2018年9月-2021年9月于武汉大学人民医院神经内科就诊的115例诊断为ALS的患者,通过问卷调查获取患者的一般人口统计学数据、匹兹堡睡眠质量量表(Pittsburgh sleep quality scale,PSQI)评分、爱泼沃斯嗜睡量表(Epworth sleepiness score,ESS)评分、肌萎缩侧索硬化功能评分量表(Amyotrophic lateral sclerosis function rating scale,ALSFRS-R)评分,并计算进展率(ΔFS),分析各因素与睡眠质量的相关性。结果(1)不同起病部位亚组的睡眠质量、功能评分未见明显差异;(2)43%的ALS患者PSQI>7分,15%的患者ESS>9分;(3)PSQI与ALSFRS-R评分呈负相关(r=-0.36,P<0.01),与ΔFS呈正相关(r=0.25,P=0.01)。此外,PSQI与ALSFRS-R延髓功能域评分呈负相关(r=-0.21,P=0.03),与ALSFRS-R精细功能域评分呈负相关(r=-0.29,P<0.01),与ALSFRS-R粗大动作域评分呈负相关(r=-0.41,P<0.0001),与ALSFRS-R呼吸功能域评分呈负相关(r=-0.34,P<0.01)。结论ALS患者存在明显夜间睡眠问题,且睡眠质量与疾病进展、各区域功能丧失均显著相关。

Objective To analyze the correlation between the prevalence of sleep disorders in amyotrophic lateral sclerosis(ALS) and the important functional domains of sleep quality and ALS functional score. Methods A total of 115 patients diagnosed with ALS who visited the Department of Neurology, Renmin Hospital of Wuhan University from September 2018 to September 2021 were collected. General demographic data, Pittsburgh Sleep Quality Scale(PSQI) score, Epworth Sleepiness Scale(ESS) score, and amyotrophic lateral sclerosis Function Scale(ALSFRS-R) scores were obtained, and progression rate(Δ FS) was calculated to analyze the correlation between each factor and sleep quality. Results(1)There was no significant difference in sleep quality and functional scores among subgroups with different onset sites.(2)43% of ALS patients had PSQI > 7 and 15% had ESS > 9.(3) PSQI and ALSFRS-R scores were negatively correlated(r=-0.36, P<0.01), and PSQI was positively correlated with ΔFS(r=0.25, P=0.01). In addition, PSQI was negatively correlated with ALSFRS-R bulbar functional domain score(r=-0.21, P=0.03), and was negatively correlated with fine functional domain score, ALSFRS-R gross motion domain score and ALSFRS-R respiratory functional domain score(r=-0.29, P<0.01;r=-0.41, P<0.0001;r=-0.34, P<0.01, respectively). Conclusion Patients with ALS have obvious sleep problems at night, and sleep quality is significantly correlated with disease progression and loss of function in various regions.