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目的探讨多导睡眠图(PSG)和白天多次小睡潜伏期试验(MSLT)2种生理学方法对白天过度嗜睡(EDS)患儿的评估。方法对睡眠相关呼吸障碍组、发作性睡病组及特发性嗜睡组共61例不同病因的EDS患儿行整夜PSG和白天MSLT检查。MSLT在PSG结束2～3 h开始第1次MSLT,以后以每2 h行1次检查的间隔依次进行第2-5次试验,检查前1周禁用对睡眠有影响的药物。结果 44例发作性睡病中36例(81.8%)符合MSLT诊断标准;MSLT 2指标中,3组平均睡眠潜伏期比较差异无统计学意义(F=1.348,P>0.05);发作性睡病组入睡期快速眼动睡眠显著高于特发性嗜睡组和睡眠相关呼吸障碍组(F=21.81,P<0.01);PSG指标中总睡眠时间(TST)、睡眠潜伏期、睡眠效率、非快速动眼动睡眠(NREM)2期和3+4期比例、REM比例3组间差异均无统计学意义(Pa>0.05),特发性嗜睡组NREM 1期比例显著低于其他2组(P<0.01),发作性睡病组REM潜伏期显著短于其他2组(Pa<0.01),睡眠相关呼吸障碍组呼吸暂停低通气指数和最低血氧饱和度与其余2组比较差异有统计学意义(Pa<0.01)。结论MSLT/PSG任何单一的方法评价儿童EDS都是片面和不完整的,二者联合可对儿童EDS做出更全面客观的评估。
Objective To evaluate the effects of polysomnography (PSG) and nimble nocturnal nocturnal nocturnal (MSLT) test on children with daytime hypersomnia (EDS). Methods A total of 61 EDS children with different etiology from sleep disorder group, narcolepsy group and idiopathic narcolepsy group underwent overnight PSG and daytime MSLT examinations. MSLT started the first MSLT at 2 ~ 3 h after the end of PSG, and then performed the second to fifth tests at intervals of 1 h every 2 h. The sleep-deprived drugs were forbidden one week before the test. Results Thirty-six patients (81.8%) met the criteria of MSLT in 44 patients with narcolepsy. There was no significant difference in mean sleep latency between the three groups (F = 1.348, P> 0.05) REM sleep sleep was significantly higher in idiopathic drowsiness group and sleep-related respiratory disorder group (F = 21.81, P <0.01); PSG index in total sleep time (TST), sleep latency, sleep efficiency, There was no significant difference in REM ratio between the two groups (P> 0.05), and the proportion of NREM in idiopathic daytime sleepiness group was significantly lower than that in the other two groups (P <0.01) ), And latency to sleep onset was significantly shorter than those in the other two groups (Pa <0.01). The sleep apnea-hypopnea index and minimum oxygen saturation in sleep-disordered breathing group were significantly different from the other two groups (Pa < 0.01). Conclusion Any single method of MSLT / PSG evaluation of children with EDS is one-sided and incomplete. The combination of the two can make a more comprehensive and objective assessment of children’s EDS.