PDF(Pubmed)
Abstract：
Excessive daytime sleepiness is a common presenting symptom that may present a diagnostic challenge for the sleep medicine clinician. We present a case of an adolescent female with excessive daytime sleepiness and \"sleep attacks\" who was evaluated using a 2-week sleep log, wrist actigraphy, baseline polysomnogram, and Multiple Sleep Latency Test. Multiple Sleep Latency Test results noted a short mean sleep latency without sleep onset rapid eye movement periods, concerning for possible central disorders of hypersomnolence. However, actigraphy data noted a habitual bedtime of midnight or later, resulting in less than recommended total sleep time for her age on weekdays with extended sleep periods on the weekends. The most unique actigraphy finding was exposure to ambient light throughout most overnight sleep periods. When actigraphy results were discussed with the patient, she revealed recent onset of severe anxiety with fear of sleeping in the dark. This case highlights the importance of thorough clinical evaluation, and careful interpretation of objective tests, when evaluating for causes of excessive daytime sleepiness.
Dang L, Kanney ML, Hsu DP. The curious case of the Zzz\'s. J Clin Sleep Med. 2023;19(5):1009-1012.
Dang L, Kanney ML, Hsu DP. The curious case of the Zzz\'s. J Clin Sleep Med. 2023;19(5):1009-1012.
摘要：
白天过度嗜睡（EDS）是一种常见的症状，可能对睡眠医学临床医生提出诊断挑战。我们介绍了一例患有EDS和“睡眠攻击”的青春期女性，使用2周的睡眠日志进行评估，腕关节肌动,基线多导睡眠图（PSG），和多重睡眠延迟测试(MSLT)。MSLT结果表明，在没有睡眠开始REM周期的情况下，平均睡眠潜伏期较短，关于嗜睡过度的可能的中枢紊乱。然而,活动数据记录了午夜或更晚的习惯就寝时间，导致她工作日的睡眠时间少于建议的总睡眠时间，周末的睡眠时间延长。最独特的活动记录发现是在大多数夜间睡眠期间暴露于环境光。当与患者讨论活动记录结果时，她透露最近由于害怕在黑暗中睡觉而出现了严重的焦虑。这个案例突出了全面临床评估的重要性，对客观测试的仔细解释，在评估EDS的原因时。
