REM sleep characteristics in narcolepsy and REM sleep behavior disorder
REM sleep characteristics in narcolepsy and REM sleep behavior disorder
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DOI：
10.1093/sleep/30.7.844
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发表时间：
2007-07-01
期刊：
影响因子：
5.6
通讯作者：
Montplaisir, Jacques
中科院分区：
文献类型：
--
作者：
Dauvilliers, Yves;Rompre, Sylvie;Montplaisir, Jacques
研究目的：探讨发作性睡病患者快速眼动睡眠行为障碍（RBD）的多导睡眠图特征；量化发作性睡病患者、“特发性”RBD患者和正常对照者的快速眼动睡眠参数。设计：睡眠实验室研究参与者：16例发作性睡病和猝倒患者与16例特发性RBD患者和16例正常对照，年龄和性别相匹配。测量和结果：与正常对照相比，发作性睡症患者无张力的快速眼动睡眠、相性肌电图（EMG）活动和快速眼动密度的百分比更高。相比之下，RBD患者无张力的快速眼动睡眠比例更高，但快速眼动睡眠密度低于发作性睡病患者和正常对照。根据快速眼动睡眠伴弛缓率80%的阈值，50%的发作性睡病患者和87.5%的RBD患者存在异常的快速眼动睡眠肌肉活动。发作性睡病患者和对照组在快速眼动睡眠中均未发现明显的行为表现。我们还发现，与对照组相比，发作性睡病患者在清醒（PLMW）和睡眠（PLMS）期间的周期性腿部运动频率更高。结论：本研究表明，与对照组相比，发作性睡患者的快速眼动睡眠运动调节异常，且无张力、相性肌电事件和PLMS的快速眼动睡眠频率增加。除了PLMS指数外，这些异常在RBD患者中比在发作性睡病患者中更为明显。我们认为下丘脑分泌素/多巴胺能系统的功能障碍可能导致快速眼动睡眠中的运动控制障碍，从而导致睡眠/觉醒状态的分离。
Study Objectives: To assess the presence of polysomnographic characteristics of REM asleep behavior disorder (RBD) in narcolepsy; and to quantify REM sleep parameters in patients with narcolepsy, in patients with "idiopathic" RBD, and in normal controls.Design: Sleep laboratory studyParticipants: Sixteen patients with narcolepsy and cataplexy matched for age and sex with 16 patients with "idiopathic" RBD and with 16 normal controls were studied.Measurements and Results: Higher percentages of REM sleep without atonia, phasic electromyographic (EMG) activity, and REM density were found in patients with narcolepsy than normal controls. In contrast, RBD patients had a higher percentage of REM sleep without atonia but a lower REM density than patients with narcolepsy and normal controls. Based on a threshold of 80% for percentage of REM sleep with atonia, 50% of narcoleptics and 87.5% of RBD patients had abnormal REM sleep muscle activity. No significant behavioral manifestation in REM sleep was noted in either narcoleptics or controls. We also found a higher frequency of periodic leg movements during wake (PLMW) and during sleep (PLMS) in narcoleptic patients compared to controls.Conclusions: The present study demonstrates abnormalities in REM sleep motor regulation with an increased frequency of REM sleep without atonia, phasic EMG events and PLMS in narcoleptic patients when compared to controls. These abnormalities were seen more prominently in patients with RBD than in narcoleptics, with the exception of the PLMS index. We proposed that dysfunctions in hypocretin/dopaminergic system may lead to motor dyscontrol in REM sleep that results in dissociated sleep/wake states.