Sleep-stage transitions during polysomnographic recordings as diagnostic features of type 1 narcolepsy.
Sleep-stage transitions during polysomnographic recordings as diagnostic features of type 1 narcolepsy.
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DOI：
10.1016/j.sleep.2015.06.007
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发表时间：
2015-12
期刊：
影响因子：
4.8
通讯作者：
Mignot E
中科院分区：
文献类型：
--
作者：
Christensen JA;Carrillo O;Leary EB;Peppard PE;Young T;Sorensen HB;Jennum P;Mignot E
1型发作性睡病/下丘脑泌素缺乏症的特征是白天过度嗜睡、睡眠片段化和突然发作。在夜间多导睡眠图（PSG）或多次睡眠潜伏期试验（MPEST）的小睡期间，短REM潜伏期（≤15 min）定义了睡眠开始REM睡眠期（SOREMP），这是一个诊断标志。我们假设在1型发作性睡病中除了SOREMPs以外的异常睡眠转换可以被识别。从PSG中提取睡眠阶段转换（一到10个时期到任何其他阶段的一到五个时期）和回合长度特征（一到10个时期）。当记录夜间SOREMP时，排除前15分钟的睡眠。使用F0.1指标和受试者工作特征（ROC）曲线来识别特定（≥ 98%）特征。136名患者和510名性别和年龄匹配的对照组的数据集用于训练。一个数据集的19例和708例睡眠诊所的患者被用于验证。(1)从N1或W期≥5次到REM期≥2次的转换≥5次，从N2或N3期≥3次到N1或W期≥2次的转换≥22次，以及从N1或W期≥6次到N1或W期≥16次的转换具有高度特异性（≥98%）。灵敏度范围为16- 30%，在有无药物或夜间SOREMP的情况下无显著差异。在服用抗抑郁药的患者中，夜间SOREMP的发生率要低得多（16% vs 36%，p<0.001）。睡眠阶段转换增加，特别是从≥2.5分钟的W/N1到REM，是独立于夜间SOREMP的发作性睡病的特异性诊断。
Type 1 narcolepsy/hypocretin deficiency is characterized by excessive daytime sleepiness, sleep fragmentation and cataplexy. Short REM latency (≤15 min) during nocturnal polysomnography (PSG) or during naps of the Multiple Sleep Latency Test (MSLT) defines a sleep onset REM sleep period (SOREMP), a diagnostic hallmark. We hypothesized that abnormal sleep transitions other than SOREMPs can be identified in type 1 narcolepsy. Sleep stage transitions (one to 10 epochs to one to five epochs of any other stage) and bout length features (one to 10 epochs) were extracted from PSGs. The first 15 min of sleep were excluded when a nocturnal SOREMP was recorded. F0.1 measures and receiver operating characteristic (ROC) curves were used to identify specific (≥ 98%) features. A data set of 136 patients and 510 sex- and age-matched controls was used for the training. A data set of 19 cases and 708 sleep-clinic patients was used for the validation. (1) ≥5 transitions from ≥5 epochs of stage N1 or W to ≥2 epochs of REM sleep, (2) ≥22 transitions from ≥3 epochs of stage N2 or N3 to ≥2 epochs of N1 or W, and (3) ≥16 bouts of ≥6 epochs of N1 or W were found to be highly specific (≥98%). Sensitivity ranged from 16–30%, and it did not vary substantially with and without medication or a nocturnal SOREMP. In patients taking antidepressants, nocturnal SOREMPs occurred much less frequently (16% .vs 36%, p<0.001). Increased sleep stage transitions, notably from ≥2.5 min of W/N1 into REM are specifically diagnostic for narcolepsy independent of a nocturnal SOREMP.
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影响因子：
29
作者：
Andlauer, Olivier;Moore, Hyatt;Jouhier, Laura;Drake, Christopher;Peppard, Paul E.;Han, Fang;Hong, Seung-Chul;Poli, Francesca;Plazzi, Giuseppe;O'Hara, Ruth;Haffen, Emmanuel;Roth, Thomas;Young, Terry;Mignot, Emmanuel
通讯作者：
Mignot, Emmanuel
影响因子：
64.5
作者：
Lin, L;Faraco, J;Mignot, E
通讯作者：
Mignot, E
影响因子：
64.5
作者：
Chemelli, RM;Willie, JT;Yanagisawa, M
通讯作者：
Yanagisawa, M
影响因子：
82.9
作者：
Peyron, C;Faraco, J;Mignot, E
通讯作者：
Mignot, E
影响因子：
4.8
作者：
Drakatos, Panagis;Kosky, Christopher A.;Leschziner, Guy D.
通讯作者：
Leschziner, Guy D.