睡眠相关节律性运动不同临床表型的多导睡眠图特征  

Polysomnographic characteristics of different clinical phenotypes of sleep related rhythmic movement(SRRM)

作　　者：张帅美 邓丽影[1] 丁勇民[1] ZHANG Shuaimei;DENG Liying;DING Yongmin(The Second Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第二附属医院,江西南昌330000

出　　处：《中风与神经疾病杂志》2020年第11期968-972,共5页Journal of Apoplexy and Nervous Diseases

基　　金：江西省重点研发计划(No.20161BBG70195)。

摘　　要：目的了解睡眠相关的节律性运动(SRRM)不同临床表型的视频多导睡眠图(V-PSG)特征。方法将2017年12月-2020年8月在本睡眠中心经视频多导睡眠监测诊断的21例睡眠相关的节律性运动患者分成撞头型、晃头型、身体摇摆型、其它型、混合型,对其临床资料、各型V-PSG特点及睡眠质量进行分析评估。结果959例睡眠监测病例中21例(2.19%)被诊断SSRM,其中男性16例(76.2%),女性5例(23.8%),平均年龄27.29±11.64岁,≥18岁有17例。SRRM首发于成人9例(42.9%),儿童期发病4例(19.0%),首发年龄不清4例(19.0%),4例(19.0%)为青少年患者;21例患者运动频率均低于0.5次/s。临床表现为晃头型10例(47.6%),身体摇摆型1例(4.8%),混合型10例(47.6%);SSRM发生在REM期14例(66.7%),NREM2期2例(9.5%),NREM2+REM期3例(14.3%),清醒及NREM1期2例(9.5%);PSG显示SSRM者睡眠效率减低,REM潜伏期延长及睡后觉醒总时间延长,睡眠总时间及睡眠分期比率大致正常;汉密尔顿焦虑评分大于8分12例(57.14%)。结论成人SSRM并不少见,多为成年后首发,男性多见。成年人SSRM主要为表现为晃头型及混合型,REM期出现频率最高。需要进一步研究和评估SSRM诊治临床意义及与REM睡眠的关系。Objective To analyze characteristics of video polysomnography(V-PSG)for different clinical phenotypes of sleep related rhythmic movement(SRRM).Methods The clinical data of patients with sleep related rhythmic movement diagnosed by video polysomnography(V-PSG)monitoring in our sleep center from December 2017 to August 2020 were analyzed retrospectively,their genders,ages,first episode time,clinical types and PSG results were statistically analyzed.Results A total of 21 SSRM patients were performed in 959 sleep monitoring cases,including 16 males(76.2%)and 5 females(23.8%).The mean age was 27.29±11.64 years old,and 17 cases were≥18 years old.SSRM first occurred in 9 adults(42.9%),4 children(19%),4 patients(19.0%)with unclear onset age,and 4 patients(19.0%)with adolescent onset.The movement frequency of 21 cases(100%)was lower than 0.5 times per second.The clinical manifestations were head shaking type in 10 cases(47.6%),body shaking type in 1 case(4.8%)and mixed type in 10 cases(47.6%).14 cases occurred REM in SSRM cases(66.7%),NREM22 cases(9.5%%),NREM2+REM 3 cases(14.3%),and awake 2 cases(9.5%).PSG showed that the sleep efficiency of SSRM patients was decreased,the latency period of REM was prolonged and the total waking time after sleep was prolonged,and the total sleep time and sleep stage ratio were approximately normal.Hamilton anxiety score was greater than 8 in 12 cases(57.14%).Conclusion Adult SSRM is not uncommon,and it is mostly the first episode in adult life.In adults,SSRM is mainly manifested as head shaking type and mixed type,and the occurrence frequency of REM is the highest.The clinical significance of SSRM and its relationship with REM sleep need to be further studied and evaluated.

关 键 词：睡眠 节律性运动 快速眼动期睡眠 表型 视频多导睡眠监测 

分 类 号：R338.63[医药卫生—人体生理学]