Loss of REM sleep features across nighttime in REM sleep behavior disorder
Loss of REM sleep features across nighttime in REM sleep behavior disorder
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DOI：
10.1016/j.sleep.2015.10.019
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发表时间：
2016-01-01
期刊：
影响因子：
4.8
通讯作者：
Arnulf, Isabelle
中科院分区：
文献类型：
--
作者：
Arnaldi, Dario;Latimier, Alice;Arnulf, Isabelle
目的：褪黑激素是一种时间生物素治疗剂，也可缓解快速眼动（REM）睡眠行为障碍（RBD）。由于这种益处的机制尚不清楚，我们评估了RBD患者（无论是特发性（iRBD）还是与帕金森病（PD）相关）的时钟依赖性REM睡眠特征，并将结果与无RBD的PD患者和健康受试者进行了比较。对10名iRBD患者、10名患有RBD的PD患者（PD + RBD+）、10名没有RBD的PD患者（PD + RBD）和10名对照者进行了过夜视频睡眠描记术。每分钟的快速眼动频率（REM指数），紧张性和阶段性肌电图（EMG）的提上睑肌活动，以及每个REM睡眠事件的持续时间进行了评估。在每组中应用广义线性模型，REM睡眠周期（四个有序水平）作为因变量，作为REM指数、REM睡眠持续时间、紧张性和阶段性EMG活动的函数。从第一个到第四个睡眠周期，REM睡眠持续时间仅在对照组中逐渐增加，REM指数在无RBD的受试者中增加，但在RBD患者中没有增加，无论是特发性或与PD，而紧张性和阶段性EMG活动并没有改变conclusion.Conclusions：PD或iRBD患者失去了REM睡眠持续时间的生理夜间增加，和患者没有（无论有或没有PD）失去了整个夜间REM 5频率的增加，这表明在RBD的昼夜节律系统的改变。这支持了褪黑激素通过其生物钟活性对RBD症状的直接影响的假设。(C)2015爱思唯尔B.V.保留所有权利。
Objectives: Melatonin is a chronobiotic treatment which also alleviates rapid eye movement (REM) sleep behavior disorder (RBD). Because the mechanisms of this benefit are unclear, we evaluated the clock dependent REM sleep characteristics in patients with RBD, whether idiopathic (iRBD) or associated with Parkinson's Disease (PD), and we compared findings with PD patients without RBD and with healthy subjects.Methods: An overnight videopolysomnography was performed in ten iRBD patients, ten PD patients with RBD (PD + RBD+), ten PD patients without RBD (PD + RBD), and ten controls. The rapid eye movement frequency per minute (REMs index), the tonic and phasic electromyographic (EMG) activity of the levator mend muscle, and the duration of each REM sleep episode were evaluated. A generalized linear model was applied in each group, with the REM sleep cycle (four ordinal levels) as the dependent variable, as a function of REMs index, REM sleep duration, and tonic and phasic EMG activity.Results: From the first to the fourth sleep cycle, REM sleep duration progressively increased in controls only, REMs index increased in subjects without RBD but not in patients with RBD, whether idiopathic or associated with PD, whereas tonic and phasic EMG activity did not change.Conclusions: Patients with PD or iRBD lost the physiologic nocturnal increase in REM sleep duration, and patients with no (either with or without PD) lost the increase of REM5 frequency across the night, suggesting an alteration in the circadian system in RBD. This supports the hypothesis of a direct effect of melatonin on RBD symptoms by its chronobiotic activity. (C) 2015 Elsevier B.V. All rights reserved.