First rapid eye movement sleep periods and sleep-onset rapid eye movement periods in sleep-stage sequencing of hypersomnias
First rapid eye movement sleep periods and sleep-onset rapid eye movement periods in sleep-stage sequencing of hypersomnias
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DOI：
10.1016/j.sleep.2013.03.021
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发表时间：
2013-09-01
期刊：
影响因子：
4.8
通讯作者：
Leschziner, Guy D.
中科院分区：
文献类型：
--
作者：
Drakatos, Panagis;Kosky, Christopher A.;Leschziner, Guy D.
目的：发作性睡病、特发性睡眠过度和行为诱发的睡眠不足综合征（BIISS）之间的鉴别是基于临床特征和特定的夜间多导睡眠图（NPSG）和多次睡眠潜伏期试验（MPEST）结果。然而，以往的研究对这些诊断工具的特异性和敏感性提出了质疑。方法：回顾性分析了101例NPSG的11个变量，其中发作性睡病伴惊厥（N + C）（n = 24），发作性睡病不伴惊厥（N-C）（n = 38），特发性睡眠过度伴长睡眠期（IHL）（n = 21），结果：24例N + C患者中15例和38例N-C患者中8例从睡眠第1期（N1）或清醒期（W）进入第一快眼动期（FREMP），而其他患者组中未出现这种睡眠期序列。FREMP阶段序列是N + C和N-C组REM睡眠潜伏期（REML）的函数。FREMP分期顺序与N + C组的平均睡眠潜伏期（MSL）无关，但与N-C组相关，这意味着N-C组内的异质性。REML也是一个有用的工具。根据截止期，REML的敏感性和特异性高达85.5%和97.4%，respectives.Conclusions：FREMP阶段序列可能是一个有用的工具，在发作性睡病的诊断，特别是在结合睡眠阶段序列分析睡眠发作REM期（SOREMPs）在MPEG 2;它也可以提供一个有用的中间表型，在澄清异质性的N-C诊断组。然而，需要更大规模的前瞻性研究来证实这些发现。(C)2013爱思唯尔有限公司版权所有。
Objectives: Discrimination between narcolepsy, idiopathic hypersomnia, and behavior-induced inadequate sleep syndrome (BIISS) is based on clinical features and on specific nocturnal polysomnography (NPSG) and multiple sleep latency test (MSLT) results. However, previous studies have cast doubt on the specificity and sensitivity of these diagnostic tools.Methods: Eleven variables of the NPSG were analyzed in 101 patients who were retrospectively diagnosed with narcolepsy with cataplexy (N + C) (n = 24), narcolepsy without cataplexy (N-C) (n = 38), idiopathic hypersomnia with long sleep period (IHL) (n = 21), and BIISS (n = 18).Results: Fifteen out of 24 N + C and 8 out of 38 N-C entered the first rapid eye movement (REM) sleep period (FREMP) from sleep stage 1 (N1) or wake (W), though this sleep-stage sequence did not arise in the other patient groups. FREMP stage sequence was a function of REM sleep latency (REML) for both N + C and N-C groups. FREMP stage sequence was not associated with mean sleep latency (MSL) in N + C but was associated in N-C, which implies heterogeneity within the N-C group. REML also was a useful discriminator. Depending on the cutoff period, REML had a sensitivity and specificity of up to 85.5% and 97.4%, respectively.Conclusions: The FREMP stage sequence may be a useful tool in the diagnosis of narcolepsy, particularly in conjunction with sleep-stage sequence analysis of sleep-onset REM periods (SOREMPs) in the MSLT; it also may provide a helpful intermediate phenotype in the clarification of heterogeneity in the N-C diagnostic group. However, larger prospective studies are necessary to confirm these findings. (C) 2013 Elsevier B.V. All rights reserved.