Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection o...Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale （ESS） and multiple sleep latency test （MSLT） and diagnostic accuracy of ESS in assessing EDS in OSAHS patients. Methods The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS （mean sleep latency （MSL） 〈10 minutes） was evaluated by calculating the area under ROC curve. Results As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS （shorter MSL） were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 （95% CI： 0.71 to 0.88） and ESS score 〉12 provided the best predictive value with a sensitivity of 80% and specificity of 69%. Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.展开更多
发作性睡病是一种罕见的、致残的中枢神经系统过度睡眠,表现为白天过度困倦(excessive daytime sleepness,EDS)、猝倒、夜间睡眠障碍和与快速眼动睡眠(rapid eye movement,REM)相关的现象(睡眠瘫痪、幻觉),最新国际睡眠障碍分类第三版(I...发作性睡病是一种罕见的、致残的中枢神经系统过度睡眠,表现为白天过度困倦(excessive daytime sleepness,EDS)、猝倒、夜间睡眠障碍和与快速眼动睡眠(rapid eye movement,REM)相关的现象(睡眠瘫痪、幻觉),最新国际睡眠障碍分类第三版(International Classification of Sleep Disorder the 3ird edition,ICSD-3)将发作性睡病分为两种类型:1型发作性睡病(narcolepsy type 1,NT1)和2型发作性睡病(narcolepsy type 2,NT2)。目前自身免疫介导的下丘脑泌素/食欲素系统功能障碍被认为是发作性睡病合并猝倒的根本原因。发作性睡病患者症状出现在10岁到35岁之间。我们报道1例表现为睡眠增多伴发作性言语不能、面颈部肌无力的老年发作性睡病患者,旨在提高对本病的认识,减少误诊和漏诊。展开更多
目的:分析儿童发作性睡病(NRL)临床特征。方法:2015年1月至2016年12月就诊于院神经科门诊的56例诊断为NRL患儿,进行常规EEG、长程视频脑电图(VEEG)及多次睡眠潜伏试验(MSLT)检查;对曾经误诊病例,探讨其误诊原因。结果:56例均有不同程度...目的:分析儿童发作性睡病(NRL)临床特征。方法:2015年1月至2016年12月就诊于院神经科门诊的56例诊断为NRL患儿,进行常规EEG、长程视频脑电图(VEEG)及多次睡眠潜伏试验(MSLT)检查;对曾经误诊病例,探讨其误诊原因。结果:56例均有不同程度多睡。38例(67.9%)有猝倒表现,4例(7.1%)伴睡前幻觉,2例(3.6%)伴醒时幻觉。2例(3.6%)伴睡眠瘫痪。56例EEG背景活动均正常,VEEG排除癫痫发作。MSLT结果:所有患儿平均睡眠潜伏期缩短,快速眼动相睡眠(REM)睡眠潜伏期缩短,56例均<5min,均有2次或2次以上睡眠开始时快速眼动相睡眠(sleep onset REM periods,SOREMP)。误诊分析:8例(14.3%)曾被误诊为眼肌型重症肌无力,12例(21.4%)曾被误诊为癫痫,2例(3.6%)曾被误诊为精神分裂症。28例轻症患儿予神经科门诊随访。2例存在多睡、猝倒、睡眠幻觉,家长未允其接受药物治疗,仅予行为指导。26例严重多睡患儿给予哌甲酯或哌甲酯缓释剂治疗,并结合行为指导。结论:儿童NRL容易误诊。应密切随访患儿临床症状变化,结合VEEG及MSLT等多种辅助检查进行分析,减少误诊。展开更多
目的：研究多次睡眠潜伏期试验(multiple sleep latency test MSLT)方法和操作步骤。方法：应用多导睡眠图(PSG)进行多次睡眠潜伏期试验,分析多次试验的睡眠次数、睡眠潜伏期和REM出现次数。结果：该方法取得了较好的临床应用效果。结论...目的：研究多次睡眠潜伏期试验(multiple sleep latency test MSLT)方法和操作步骤。方法：应用多导睡眠图(PSG)进行多次睡眠潜伏期试验,分析多次试验的睡眠次数、睡眠潜伏期和REM出现次数。结果：该方法取得了较好的临床应用效果。结论：MSLT对发作性睡病、阻塞性睡眠呼吸暂停、原发性嗜睡症和睡眠中周期性腿动等疾病的诊断和鉴别诊断具有重要参考价值。展开更多
基金This study was supported by grants fi-om the National Natural Science Foundation of China （NSFC） （No. 81170070, No. 81270147）, and from the Scientific Research Foundation of the Chinese Ministry of Health （No. W2012w4）.
文摘Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale （ESS） and multiple sleep latency test （MSLT） and diagnostic accuracy of ESS in assessing EDS in OSAHS patients. Methods The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS （mean sleep latency （MSL） 〈10 minutes） was evaluated by calculating the area under ROC curve. Results As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS （shorter MSL） were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 （95% CI： 0.71 to 0.88） and ESS score 〉12 provided the best predictive value with a sensitivity of 80% and specificity of 69%. Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.
文摘发作性睡病是一种罕见的、致残的中枢神经系统过度睡眠,表现为白天过度困倦(excessive daytime sleepness,EDS)、猝倒、夜间睡眠障碍和与快速眼动睡眠(rapid eye movement,REM)相关的现象(睡眠瘫痪、幻觉),最新国际睡眠障碍分类第三版(International Classification of Sleep Disorder the 3ird edition,ICSD-3)将发作性睡病分为两种类型:1型发作性睡病(narcolepsy type 1,NT1)和2型发作性睡病(narcolepsy type 2,NT2)。目前自身免疫介导的下丘脑泌素/食欲素系统功能障碍被认为是发作性睡病合并猝倒的根本原因。发作性睡病患者症状出现在10岁到35岁之间。我们报道1例表现为睡眠增多伴发作性言语不能、面颈部肌无力的老年发作性睡病患者,旨在提高对本病的认识,减少误诊和漏诊。
文摘目的:分析儿童发作性睡病(NRL)临床特征。方法:2015年1月至2016年12月就诊于院神经科门诊的56例诊断为NRL患儿,进行常规EEG、长程视频脑电图(VEEG)及多次睡眠潜伏试验(MSLT)检查;对曾经误诊病例,探讨其误诊原因。结果:56例均有不同程度多睡。38例(67.9%)有猝倒表现,4例(7.1%)伴睡前幻觉,2例(3.6%)伴醒时幻觉。2例(3.6%)伴睡眠瘫痪。56例EEG背景活动均正常,VEEG排除癫痫发作。MSLT结果:所有患儿平均睡眠潜伏期缩短,快速眼动相睡眠(REM)睡眠潜伏期缩短,56例均<5min,均有2次或2次以上睡眠开始时快速眼动相睡眠(sleep onset REM periods,SOREMP)。误诊分析:8例(14.3%)曾被误诊为眼肌型重症肌无力,12例(21.4%)曾被误诊为癫痫,2例(3.6%)曾被误诊为精神分裂症。28例轻症患儿予神经科门诊随访。2例存在多睡、猝倒、睡眠幻觉,家长未允其接受药物治疗,仅予行为指导。26例严重多睡患儿给予哌甲酯或哌甲酯缓释剂治疗,并结合行为指导。结论:儿童NRL容易误诊。应密切随访患儿临床症状变化,结合VEEG及MSLT等多种辅助检查进行分析,减少误诊。
文摘目的：研究多次睡眠潜伏期试验(multiple sleep latency test MSLT)方法和操作步骤。方法：应用多导睡眠图(PSG)进行多次睡眠潜伏期试验,分析多次试验的睡眠次数、睡眠潜伏期和REM出现次数。结果：该方法取得了较好的临床应用效果。结论：MSLT对发作性睡病、阻塞性睡眠呼吸暂停、原发性嗜睡症和睡眠中周期性腿动等疾病的诊断和鉴别诊断具有重要参考价值。
