PUPILLOMETRIC SLEEPINESS IN TREATED SLEEP DISORDERS

患有阻塞性睡眠呼吸暂停和发作性睡病的患者由于与这些疾病相关的病理性日间过度嗜睡（EDS）而可能经历生活质量下降、生产力下降以及工作场所和交通事故。目前，EDS的程度是由多导睡眠图和多次睡眠潜伏期测试（MPEG4）确定的，这两种基于EEG的生理性嗜睡测量是劳动密集型的，耗时的，昂贵的，并且获得有限的健康保险覆盖。当人们昏昏欲睡时，他们的瞳孔会大幅摆动，并且缩小。在本研究中，将计算瞳孔不安指数（PUI），以使用台式瞳孔测量法（一种有效、方便、无创且易于重复的技术）估计嗜睡。PUI定量描述了15分钟警觉性测试期间瞳孔振荡的程度。没有将PUI与其他生理性嗜睡指标进行比较的定量数据。该重复测量、已知组方法学研究的受试者队列将包括正常对照组、常规治疗前后的阻塞性睡眠呼吸暂停和嗜睡症受试者。具体目的是（1）在受试者组中将PUI与MPEG 1睡眠延迟相关联; 92）在三个受试者组中将PUI与MPEG 1在检测嗜睡方面进行比较;以及（3）在受试者组之间以及在OSA和发作性睡病受试者中在常规治疗之前和之后将PUI和MPEG 1与其他客观和主观嗜睡测量进行比较。MANOVA将用于检查受试者组之间PUI和MPERS之间的线性关系，以及受试者组之间以及患有OSA和嗜睡症的受试者治疗前后的感觉嗜睡、睡眠量、睡眠质量和连续性、情绪和功能状态测量的差异。PUI检测嗜睡的灵敏度和特异性将使用MPERT结果作为受试者分类的“金标准”进行估计。MLR将用于估计PUI或MVR与其他客观和主观嗜睡指标之间的关系。结果将提供证据表明，PUI作为一个可靠和有效的客观结果的清醒倾向之间的控制措施，和治疗前后的OSA和嗜睡症的主题。

Patients with obstructive sleep apnea and narcolepsy can experience a diminished quality of life, decreased productivity, and workplace and traffic accidents due to the pathologic excessive daytime sleepiness (EDS) associated with these disorders. Currently, the extent of EDS is determined by polysomnography and the Multiple-Sleep Latency Test (MSLT), two EEG-based physiologic sleepiness measures that are labor intensive, time-consuming, expensive and receive limited health insurance coverage. As people become sleepy, their pupils oscillate widely and decrease in size. In this study, the Pupil Unrest Index (PUI) will be calculated to estimate sleepiness using desk top pupillometry, an efficient, convenient, non-invasive and easily repeatable technique. The PUI quantitatively describes the extent of pupillary oscillation during 15 minutes of alertness testing. Quantitative data comparing the PUI to other physiologic sleepiness measures are not available. The subject cohorts for this repeated measures, known groups methodologic study will consist of normal controls, and obstructive sleep apnea and narcolepsy subjects before and after usual treatment. The specific aims are to (1) correlate the PUI with MSLT sleep latencies among the subject groups; 92) compare the PUI to the MSLT in detecting sleepiness among the three subject groups; and (3) compare the PUI and the MSLT to other objective and subjective sleepiness measures between subject groups, and before and after usual treatment among the OSA and narcolepsy subjects. MANOVA will be used to examine the linear relationship between the PUI and the MSLT among the subject groups, and the differences in measures of perceived sleepiness, sleep quantity, sleep quality and continuity, mood and functional status between the subject groups, and pre-post-treatment fore subjects with OSA and narcolepsy. The sensitivity and specificity of the PUI in detecting sleepiness will be estimated using the MSLT results as the "gold standard" for classifying subjects. MLR will be used to estimate the relationship between the PUI or the MSLT, and other objective and subjective sleepiness measures. Results will provide evidence about the PUI as a reliable and valid objective outcome measure of waking tendency among controls, and pre-post-treatment for OSA and narcolepsy subjects.