Periodic limb movements during sleep in alcohol dependent patients
Periodic limb movements during sleep in alcohol dependent patients
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DOI：
10.1007/s00406-002-0371-8
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发表时间：
2002-06-01
影响因子：
4.7
通讯作者：
Riemann, D
中科院分区：
文献类型：
--
作者：
Gann, H;Feige, B;Riemann, D
睡眠障碍的投诉是常见的酒精依赖患者在亚急性戒酒。睡眠障碍患者可能会表现出持续数月甚至数年的睡眠异常。在本研究中，我们研究了酒精依赖患者睡眠中的周期性肢体运动和夜间呼吸障碍是否比健康受试者更频繁，并且可能对持续戒断与戒断后复发具有预测价值。40名酒精依赖患者在三个时间点在睡眠实验室度过了三个晚上：退出后2 - 3周（T0）以及出院后6个月（T1）和T2（T2）个月的随访研究。与年龄和性别匹配的健康受试者相比，酒精依赖患者在TO时显示出显著增强的PLMS-唤醒指数，而未发现夜间呼吸的改变。与戒断患者相比，在接下来的6个月内复发的患者在TO时的PLMS唤醒指数显著升高。在判别函数分析中，PLMS-唤醒指数对55%的患者在6个月后的结果进行了正确分类。它正确地预测了80%的戒酒者和44%的患者谁relationsed.According神经生物学模型的生成PLMS和酒精依赖的病因学的多巴胺能系统的遗传决定的脆弱性进行了讨论，作为一个因素的潜在风险增加复发的酒精依赖患者的一个亚组。
Complaints of sleep disturbances are common among alcohol dependent patients during subacute abstinence. Recovered patients may show persistent sleep abnormalities for months or even years. In the present study we studied the issue whether periodic limb movements in sleep and disturbances of nocturnal respiration are more frequent in alcohol dependent patients than healthy subjects and may be of predictive value for sustained abstinence vs. relapse after withdrawal.Forty alcohol dependent patients spent three nights in the sleep laboratory at three time points: 2 to 3 weeks after withdrawal (T0) and at follow-up investigations 6 (T1) and T2 (T2) months after discharge from the hospital. Measurements of PLMS-arousal index and nocturnal respiration were performed during the first laboratory night of each measurement point.Alcohol dependent patients displayed a significantly enhanced PLMS-arousal index at TO compared to age-and gender-matched healthy subjects, whereas no alterations of nocturnal respiration were found.The PLMS-arousal index at TO was significantly elevated in patients who relapsed during the next 6 months compared to abstinent patients. In a discriminant function analysis the PLMS-arousal index classified 55% of the patients correctly with respect to outcome after 6 months. It correctly predicted 80% of abstainers and 44% of the patients who relapsed.According to neurobiological models of the generation of PLMS and the etiopathology of alcohol dependence a genetically determined vulnerability of the dopaminergic system is discussed as a factor underlying an increased risk of relapse in a subgroup of alcohol dependent patients.