论文部分内容阅读
目的了解帕金森病(Parkinson disease,PD)睡眠障碍的多导睡眠图(PSG)监测表现及睡眠结构、进程特点。方法对42例临床确诊的 PD 患者和40名健康对照者行全夜 PSG 监测,分析比较各项睡眠结构、进程参数及快速眼动睡眠(REM)期视频监测特点。结果经 PSG 监测发现,PD组入睡困难、睡眠破碎、白天过度嗜睡等的发生率(分别为73.8%、59.5%、46.1%)均高于对照组(P<0.05);PD 组患者总睡眠时间、非快速眼动睡眠2期、REM 潜伏期、睡眠效率、睡眠纺锤波密度较对照组缩短或降低(P 值分别为0.000、0.000、0.045、0.000、0.000),睡眠潜伏期、觉醒时间、觉醒次数、>5 min 的觉醒次数、Epworth 嗜睡量表评分均延长或增加(P 值分别为0.022、0.000、0.007、0.001、0.000)。另外,监测中发现 PD 组有6例(14.3%)出现睡眠始发 REM 时段,而对照组无一例出现。PD 组中有36例(85.7%)在 REM 睡眠中呈现肌电活动不消失(RWA),其中19例出现 REM 期睡眠行为障碍(RBD);对照组有6例出现 RWA,其中2例出现 RBD。统计学分析显示,PD 组 RWA、RBD的发生率(分别为85.7%、45.2%)与对照组比较差异均有统计学意义(P<0.01)。结论研究显示PD 患者睡眠结构、睡眠进程等多项睡眠参数改变;PD 患者中 RBD 发生率高,其临床症状表现形式多样,且很多时候 RBD 可先于 PD 的其他症状而早期出现。
Objective To investigate the performance of polysomnography (PSG) and sleep structure and process characteristics in Parkinson disease (PD) sleep disorders. Methods Forty-two patients with PD and 40 healthy controls underwent overnight PSG monitoring. The characteristics of sleep monitoring, process parameters and REM sleep monitoring were compared and analyzed. Results The results of PSG showed that the incidences of falling asleep, disrupted sleep and excess daytime sleepiness in PD group were significantly higher than those in control group (73.8%, 59.5% and 46.1%, respectively) (P <0.05). The total sleep time , REM 2, REM latency, sleep efficiency and sleep spindle density were decreased or decreased compared with the control group (P = 0.000,0.000,0.045,0.000,0.000, respectively), sleep latency, awakening time, awakening times, The number of awakenings> 5 min and the Epworth sleepiness scale were both prolonged or increased (P = 0.022,0.000,0.007,0.001,0.000, respectively). In addition, monitoring found that PD group, 6 patients (14.3%) sleep onset REM period, but no case of control group. Thirty-six (85.7%) patients in the PD group showed no loss of myoelectrical activity during REM sleep, of which 19 had REM sleep disturbance (RBD), 6 had RWA in the control group and 2 had RBD . Statistical analysis showed that the incidences of RWA and RBD in PD group were 85.7% and 45.2%, respectively, which were significantly different from those in control group (P <0.01). Conclusions The study showed that sleep parameters such as sleep structure and sleep progress were all changed in PD patients. The incidence of RBD was high in patients with PD, and its clinical manifestations varied. In many cases, RBD could occur earlier than other symptoms of PD.