目的研究帕金森病患者睡眠障碍发生及其特点和影响因素。方法收集患者病史资料并应用多导睡眠仪对10例帕金森病患者及5名健康对照进行多导睡眠监测。受试者分为3组:对照组、帕金森病Hoehn-Yahr(H&Y)Ⅰ级组及帕金森病H&YⅡ-Ⅳ级组。每组均包括男性3例,女性2例。结果3组年龄分别为(54.4±5、7)岁、(57.6±14.5)岁、(58.2±10.7)岁,年龄之间的差异无统计学意义(F=0.232,P=0.794)。对照组浅慢波睡眠时间为(70.6±7.8)min,而H&YⅠ级组患者浅慢波睡眠时间为(81.4±6.1)min,显著高于对照组(P=0.008);对照组睡眠效率为75、6%±12.8%,快动眼睡眠(REM)潜伏期为(116±48)min,浅慢波睡眠所占比例为70.6%±7、8%,REM所占比例为14.8%±5.5%,总睡眠时间为(372.8±53.4)min,而H&YⅡ~Ⅳ级组患者睡眠效率43.6%±16.0%(P=0.003)、REM所占比例7.3%±6.1%(P=0.003)及总睡眠时间(244.3±103.2)min(P=0.006)均显著低于对照组,REM睡眠潜伏期(281±86)min(P=0.000)及浅慢波睡眠时间(85.3±7.9)min(P=0.000)显著高于对照组。经相关分析,睡眠潜伏期、浅慢波睡眠时间与疾病病程存在显著正相关(r分别为0.889、o.492;P值分别为0.000、0.006),而睡眠效率、深慢波睡眠时间及总睡眠时间与疾病病程有显著负相关(r分别为-0.626、-0.723、-0.728:P值均为0.000)。结论研究结果显示,帕金森病患者在患病早期已经存在夜间睡眠时间减少、睡眠效率下降、睡眠潜伏期延长及睡眠结构的改变等异常,而且有随疾病进展而加重的趋势。
Objective To investigate the characteristics of the sleep disturbance in Parkinson' s disease (PD). Methods Ten PD patients and five healthy controls were subjected to polysomnography analysis. The subjects were divided into three groups: control group, PD patients with Hoehn-Yahr(H&Y) Ⅰgroup and patients with H&Y Ⅱ - Ⅳ group, respectively. Results Average age of three groups was (54. 4 ±5.7 )years old, (57.6 ± 14. 5) years old, (58. 2 ± 10. 7) years old, respectively, There were no significant differences for age in each group (F =0. 232, P =0. 794). Light slow wave sleep (ISWS) time in PD patients with H&Y I group (( 81.4 ± 6. 1 ) minutes) was significantly higher than control group ( (70. 6 ±7. 8) minutes,P =0. 008). In control group, sleep efficiency was 75.6% ± 12. 8%. REM sleep latency was( 116 ±48 ) minutes. Percentage of 1SWS and REM sleep was 70. 6% ± 7. 8% and 14. 8% ± 5. 5%. Total sleep time was (372. 8 ±53.4 )minutes. While, in PD patients with H&Y Ⅱ - Ⅳgroup, sleep efficiency (43.6% ± 16. 0% ,P = 0. 003 ) , REM sleep percentage ( 7. 3% ± 6. 1% , P = 0. 003 ) and total sleep time ( (244. 3 ± 103.2 )minutes,P =0. 006) were significantly lower than controls. REM sleep latency( (281 ±86) minutes,P =0. 000) and 1SWS ( (85. 3 ± 7. 9) minutes,P =0. 000) were significantly higher than control group. There was a positive correlation found between sleep latency, 1SWS and disease duration (r equals to 0. 889, 0. 492; P equals to 0. 000, 0. 006, respectively). Meanwhile, there were negative correlations between sleep efficiency, deep slow wave sleep, total sleep time and disease duration ( requals to - 0. 626, - 0. 723, - 0. 728 ; P equals to 0. 000, respectively ). Conclusion The results suggest that total sleep time, sleep efficiency was decreased and sleep latency was increased in PD patients. These changes might already appear in the early stage and get worsen along with the disea