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目的观察儿童发作性睡病的临床特征,了解患儿夜间睡眠结构的变化,探讨多次睡眠潜伏期试验(MSLT)在诊断发作性睡病中的价值。方法对26例发作性睡病患儿的临床资料进行分析,采用多导睡眠生理监测仪对患儿行MSLT检查,对其中18例及30例正常儿童进行整夜多导睡眠图描记(PSG)。结果①26例患儿(100%)均以睡眠过多为首发症状,9例(35%)有猝倒发作,4例(15%)有入睡前幻觉,仅2例(7%)有睡眠瘫痪。②MSLT结果:平均睡眠潜伏期均缩短,26例均<5min,18例(69%)出现2次或更多的睡眠始发REM睡眠(SOREPs)。③PSG结果:患儿睡眠潜伏期及REM潜伏期均缩短;睡眠效率降低;NREMⅠ期睡眠时间增加,Ⅲ+Ⅳ睡眠时间减少;觉醒次数增多。结论儿童发作性睡病主要以白天不可抗拒的睡眠为主,睡眠瘫痪、入睡幻觉等主观叙述较成人少。MSLT对发作性睡病的诊断具有重要参考价值。发作性睡病患儿存在睡眠结构异常。
Objective To observe the clinical features of narcolepsy in children and to understand the changes of nocturnal sleep structure in children and explore the value of multiple sleep latency test (MSLT) in the diagnosis of narcolepsy. Methods The clinical data of 26 children with narcolepsy were analyzed. MSLT was performed on children with polysomnography. Eighteen patients and 30 normal children underwent polysomnography (PSG) . Results ① Twenty-two infants (100%) had the first symptom of sleep deprivation, 9 cases (35%) had cataplexy, 4 (15%) had hallucinations before going to sleep and only 2 (7%) had sleep paralysis . Results of MSLT: The average sleep latency was shortened, all of 26 cases were less than 5 minutes and 18 cases (69%) had 2 or more sleep-onset REM sleeps (SOREPs). ③PSG results: children’s sleep latency and latency of REM were shortened; sleep efficiency decreased; NREMⅠphase sleep time increased, Ⅲ + Ⅳ sleep time decreased; awakening times increased. Conclusions Children’s narcolepsy is dominated by irresistible sleep during the day, with subjective narration such as sleep paralysis and hallucination. MSLT has an important reference value for the diagnosis of narcolepsy. Children with narcolepsy have abnormal sleep patterns.