失眠症的整夜多导睡眠图监测  

Monitoring Whole Night Polysomnography of Patients with Insomnia

作　　者：张明岛[1] 陈兴时[1] 王红星[1] 楼翡璎[1] 郭旗[2] 王继军[1] 梁建华[1] 陈欣伟[1] 高存友[3] 刘效巍[4] 李峰[5] 

机构地区：[1]上海市精神卫生中心,上海200030 [2]中南大学湘雅二医院精神卫生研究所脑电图室 [3]中国人民解放军第160医院内三科 [4]大连医科大学第一附属医院脑诱发电位室 [5]山东淄博市第五人民医院功能科

出　　处：《神经病学与神经康复学杂志》2005年第1期28-31,共4页Journal of Neurology and Neurorehabilitation

基　　金：上海市科技发展基金赞助(编号034030).

摘　　要：目的探索建立失眠症的多导睡眠图(PSG)模式。方法应用日本 Nihon Kohden 公司的 Neurofax-1518K 多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图技术,对39例失眠症患者和33名正常对照者进行 PSG 全夜监测。结果与正常组相比,失眠症组的 PSG 表现为:睡眠总时间减少(正常组464.1±22.9分,失眠症组359.7±31.5分,P<0.01),睡眠潜伏期延迟(正常组19.9±9.8分,失眠症组31.5±18.4分,P<0.01),醒觉次数多(正常组1.4±0.7次,失眠症组4.9±2.1次,P<0.01),睡眠效率低(正常组94.6±5.1%.失眠症组84.7±8.3%.P<0.01),第一阶段睡眠增加(正常组9.1±1.9%,失眠症组27.9±17.9%,P<0.01),第二阶段睡眠下降(正常组56.2±4.7%,失眠症组45.9±17.7%,P<0.01),第3,4阶段睡眠降低(正常组16.7±4.9%.失眠症组9.1±5.1%,P<0.01),REM 睡眠潜伏期缩短(正常组87.8±11.7分,失眠症组53.8±19.7分,P<0.01)。此外,失眠症组有8例(N=8/39,20.5%)的睡眠潜伏期和睡眠效率综合分析正常,但患者主诉"无睡眠感",有"主观性失眠"存在。结论失眠症患者 PSG 存在睡眠进程、睡眠结构和 REM 值的变化。睡眠潜伏期延迟和慢波睡眠 S_1增加具有更高的临床价值。本组研究还发现失眠症患者中有一部分对象可能属于"主观性失眠"。Objective To assess the changes of the whole night polysomnography(PSG)in patients with insom- nia.Methods The whole night PSG recorded the data of 39 patients with insomnia and 33 normal subjects,using Neurofax-1518K(Nihon Kohden)sleep instrument.Results Compared with normal subjects,insomnia patients showed significantly reduced total sleep duration(NC:464.1±22.9,insomnia group:359.7±31.5,P<0.01), prolonged sleep latency(NC:19.9±9.8,insomnia group:31.5±18.4,P<0.01),increased waking times(NC: 1.4±0.7,insomnia group:4.9±2.1 times,P<0.01),reduced sleep efficiency(NC:94.6±5.1%,insomnia group:84.7±8.3%,P<0.01),increased stage 1 sleep(NC:9.1±1.9%,insomnia group:27.9±17.9%,P< 0.01),decreased stage 2 and stage 3 or 4 sleep(NC:56.2±4.7%,insomnia group:45.9±17.7%,P<0.01; NC:16.7±4.9%,insomnia group:9.1±5.1%,P<0.01),and shortened REM latency(NC:87.8±11.7,in- somnia group:53.8±19.7,P<0.01).In addition,8 patients'(N=8/39,20.5%)complaint of'no sleep sense' showed normal sleep latency and sleep efficiency,which suggested those patients had subjective insomnia.Conclu- sion Patients with insomnia exhibit abnormality in sleep continuity,sleep frame,and REM,suggesting that delayed sleep latency,early awaking time,and increased stage 1 sleep might be useful index in clinical application.And some insomnia patients might be subjective insomnia.

关 键 词：失眠症 多导睡眠描记术 快速眼运动睡眠 

分 类 号：R740[医药卫生—神经病学与精神病学]