目的 探讨原发性失眠患者日间功能损害及其影响因素。 方法 选取2010年3月－12月符合美国《精神障碍诊断与统计手册》第4版诊断标准的原发性失眠者62例，另选择性别、年龄匹配的健康睡眠者53例。失眠组和对照组均采用匹茨堡睡眠质量指数量表（PSQI）评估1个月的主观睡眠质量，多导睡眠监测（PSG）评估客观睡眠质量，并通过“主观睡眠时间/客观睡眠时间×100%”计算睡眠知觉，PSG监测后受试者完成一系列日间功能评定，包括Epworth嗜睡量表（ESS）评价嗜睡程度、Flinders疲劳量表（FFS）评价疲劳程度、贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI）评估情绪状态。 结果 ① 与对照组相比，失眠组主客观睡眠质量均较差；PSQI分数更高[（14.37 ± 2.44）、（2.74 ± 1.79）分，P＜0.001）]；睡眠知觉差[（49.76 ± 33.29）、（99.36 ± 12.79）分，P＜0.001）]。② 失眠组FSS、BDI、SAI、TAI分数明显高于对照组，ESS分数低于对照组（P值均＜0.05）。③ PSQI总分与ESS呈负相关（r=−0.17，P＜0.01），与FSS、BDI、SAI、TAI分数呈正相关（r=0.54，r=0.66，r=0.70，r=0.87）（P值均＜0.01）。客观睡眠时间与ESS（r=−0.01，P=0.138）、FSS（r=−0.02，P=0.019）、BDI（r=−0.03，P=0.022）、SAI（r=−0.03，P=0.086）、TAI（r=−0.04，P=0.015）分数均无明显相关性。 结论 原发性失眠者主观睡眠质量与多项日间功能损害相关，这为有效的治疗失眠和改善日间症状提供理论依据。
ObjectiveTo assess the polysomnographic characteristics of insomnia patients with comorbid obstructive sleep apnea-hypopnea syndrome (OSAHS). MethodsWe performed a comparative analysis on the polysomnographic features among patients with pure insomnia (n=80), patients with pure OSAHS (n=80), and patients with insomnia and OSAHS (n=50) between August and December 2013. ResultsCompared with OSAHS group, patients with insomnia and comorbid OSAHS had a higher percentage of female, older age, lower body mass index, shorter total sleep time during the night, longer sleep latent period and wake after sleep onset (WASO), lower sleep efficacy, lower arousal index and apnea hypoventilation index (AHI), higher average and the lowest oxygen saturation of blood, lower Epworth Sleepiness Scale scores and sleep perception (P < 0.05). Compared with the insomnia group, patients with insomnia and comorbid OSAHS had a lower percentage of female, shorter total sleep time, lower sleep efficacy, longer WASO and higher AHI (P < 0.05). ConclusionPatients with insomnia and comorbid OSAHS have all the characteristics of insomnia and OSAHS patients:nocturnal hypoxia, sleep fragmentation, broken sleep continuity, decreased sleep efficiency, damaged perception of sleep time and sleep perception.
Objective To investigate the differences in biological features between male and female patients with obstructive sleep apnea-hypopnea syndrome( OSAHS) . Methods 192 cases of patients with snoring were analyzed in the Sleep Medicine Center of West ChinaHospital fromSeptember 2004 to February 2005. The standard sleep disorder questionnaires, neck circumference, hight, weight, and all night polysomnography ( PSG) were evaluated. The clinical features of the male and female patients with OSAHS were compared. Results 170 cases of patients met the criteria of OSAHS for the apnea-hypopnea index ( AHI) more than 5 times per hour. Male gender accounted for 90% of the total patients ( male vs. female 153 vs. 17, 9∶1) . The age of male patients with OSAHS was younger than that of female ( 45. 7 ±11. 4 yearsvs. 58. 0 ±6. 1 years, P = 0. 000) . Parameters including neck circumference ( 37. 6 ±3. 2 cm vs. 35. 6 ±3. 2 cm, P =0. 000) , waist/hip rate ( 0. 94 ±0. 04 vs. 0. 9 ±0. 06, P = 0. 000) , AHI ( 36. 4 ±25. 7 vs.21. 4 ±17. 4, P =0. 004) , oxygen desaturation index ( 34. 5 ±27. 4 vs. 22. 2 ±20. 8, P =0. 035) , the number of smoking ( 52. 9% vs. 5. 9% , P = 0. 000) and drinking ( 46. 4% vs. 5. 9% , P = 0. 001) were different among the male and female patients with OSAHS. On the other hand, the morning headache ( 70. 6% vs.26. 1%, P = 0. 005) , mouth dry( 76. 5% vs. 47. 7% , P = 0. 025) , bad temper ( 52. 9% vs. 19. 0% , P =0. 004) , and hypertension ( 52. 9% vs. 20. 9% , P =0. 007) were more common in the female patients with OSAHS. Conclusion There are significant differences between male and female patients with OSAHS in prevalence, age, symptoms, and severity of the disease.
The use of actigraphy, which can be used to estimate sleep-wake patterns from activity levels, has become common in sleep research. Actigraphy is a simple, cost-effective and non-invasive method for healthcare providers and researchers to assess patients sleep quality and screen for potential sleep disorders in recent years. But, there is no wide recognition and application of actigraphy in China up till now. This review summarized the application of actigraphy in evaluation of sleep and diagnosis of sleep disorders.
This study seeks to explore the early signs of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). According to polysomnography, twenty patients diagnosed with OSAHS and twenty normal controls underwent event-related potential (ERP) examination including mismatch negativity (MMN) and P300. Compared with normal controls, OSAHS patients showed significantly prolonged latency of MMN and P300 at Cz. After controlling age and body mass index (BMI), MMN latency positively correlated with apnea hypopnea index (AHI), oxygen reduction index, stage N1 sleep and arousal index, while MMN latency negatively correlated with stage N3 sleep and mean blood oxygen saturation; and P300 latency positively related to AHI and oxygen reduction index; no relationships were found among MMN latency, MMN amplitude, P300 latency and P300 amplitude. These results suggest that the brain function of automatic processing and controlled processing aere impaired in OSAHS patients, and these dysfunction are correlated with nocturnal repeatedly hypoxemia and sleep structure disturbance.