PUPILLOMETRIC SLEEPINESS IN TREATED SLEEP DISORDERS

阻塞性睡眠呼吸暂停和发作性睡病患者可能会经历生活质量下降，生产力下降，工作场所和交通事故，原因是与这些疾病相关的病理性日间过度嗜睡(EDS)。目前，EDS的程度是通过多导睡眠图和多重睡眠潜伏期测试(MSLT)来确定的，这两种基于脑电的生理性嗜睡测试是劳动密集型、耗时、昂贵的，而且医疗保险覆盖范围有限。当人们变得昏昏欲睡时，他们的瞳孔会大幅振荡并缩小。在这项研究中，将通过计算瞳孔不宁指数(PUI)来使用桌面瞳孔测量法来评估困倦程度，这是一种有效、方便、非侵入性和易于重复的技术。PPI定量描述了15分钟警觉性测试期间的瞳孔摆动程度。没有将PPI与其他生理嗜睡指标进行比较的定量数据。本次重复测量的受试者队列，已知分组方法学研究将包括正常对照组、阻塞性睡眠呼吸暂停和发作性睡病受试者在常规治疗前后。其具体目的是(1)将受试者组中的PUI与MSLT睡眠潜伏期相关联；92)比较PUI和MSLT在检测三组受试者之间的嗜睡情况；以及(3)将PUI和MSLT与受试组之间以及OSA和发作性睡病患者的常规治疗前后的其他客观和主观嗜睡指标进行比较。MANOVA将被用来检验受试组之间的PUI和MSLT之间的线性关系，以及受试组之间在感知困倦、睡眠数量、睡眠质量和连续性、情绪和功能状态以及治疗前和治疗后OSA和发作性睡病患者之间的差异。PUI在检测嗜睡方面的敏感度和特异度将使用MSLT结果作为对受试者进行分类的“金标准”来评估。MLR将被用来估计PUI或MSLT与其他客观和主观嗜睡指标之间的关系。结果将提供证据，证明PPI是一种可靠和有效的客观结果指标，可以衡量对照组以及OSA和发作性睡病患者治疗前的觉醒趋势。

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.