■这项研究旨在评估夜间睡眠结构和焦虑,抑郁症,1型发作性睡病(NT1)患者的疲劳。
■招募30名NT1患者和35名健康对照者,并使用Epworth嗜睡量表(ESS)进行评估,广义焦虑症-7,患者健康问卷-9,疲劳严重程度量表(FSS),多导睡眠图,多个睡眠潜伏期测试,和脑功能状态监测。使用SPSSStatisticsforWindows进行统计分析,版本23.0。进行Benjamini-Hochberg校正以控制错误发现率。
■除了典型的临床表现,NT1患者容易出现合并症,如夜间睡眠障碍,焦虑,抑郁症,和疲劳。与对照组相比,NT1患者表现出异常的睡眠结构,包括总睡眠时间增加(Padj=0.007),睡眠效率降低(Padj=0.002),睡眠发作潜伏期缩短(P<0.001),睡眠开始后清醒升高(Padj=0.002),增加N1%(P调整=0.006),并降低N2%,N3%,和REM%(Padj=0.007,Padj<0.001,Padj=0.013)。37%的患者患有中度至重度阻塞性睡眠呼吸暂停低通气综合征。60%的患者患有REM睡眠而没有失功。NT1患者焦虑倾向增加(P<0.001),在脑功能状态监测中,脑疲劳增加(Padj=0.020)。FSS评分与脑疲劳呈正相关(P<0.001),平均睡眠潜伏期与FSS评分和脑疲劳呈负相关(P=0.013,P=0.029)。此外,治疗3个月后,ESS评分和脑疲劳均降低(P=0.012,P=0.030)。
■NT1患者夜间睡眠结构异常,表现出焦虑增加的人,抑郁症,和疲劳。盐酸哌醋甲酯缓释片联合文拉法辛治疗3个月后,白天过度嗜睡和疲劳得到改善。
UNASSIGNED: This study aimed to evaluate nocturnal sleep structure and anxiety, depression, and fatigue in patients with
narcolepsy type 1 (NT1).
UNASSIGNED: Thirty NT1 patients and thirty-five healthy controls were enrolled and evaluated using the Epworth sleepiness scale (ESS), Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Fatigue Severity Scale (FSS), polysomnography, multiple sleep latency test, and brain function state monitoring. Statistical analyses were performed using SPSS Statistics for Windows, version 23.0. Benjamini-Hochberg correction was performed to control the false discovery rate.
UNASSIGNED: Apart from typical clinical manifestations, patients with NT1 are prone to comorbidities such as nocturnal sleep disorders, anxiety, depression, and fatigue. Compared with the control group, patients with NT1 exhibited abnormal sleep structure, including increased total sleep time (P adj=0.007), decreased sleep efficiency (P adj=0.002), shortening of sleep onset latency (P adj<0.001), elevated wake after sleep onset (P adj=0.002), increased N1% (P adj=0.006), and reduced N2%, N3%, and REM% (P adj=0.007, P adj<0.001, P adj=0.013). Thirty-seven percent of patients had moderate to severe obstructive sleep apnea-hypopnea syndrome. And sixty percent of patients were complicated with REM sleep without atonia. Patients with NT1 displayed increased anxiety propensity (P adj<0.001), and increased brain fatigue (P adj=0.020) in brain function state monitoring. FSS scores were positively correlated with brain fatigue (P adj<0.001) and mean sleep latency was inversely correlated with FSS scores and brain fatigue (P adj=0.013, P adj=0.029). Additionally, ESS scores and brain fatigue decreased after 3 months of therapy (P=0.012, P=0.030).
UNASSIGNED: NT1 patients had abnormal nocturnal sleep structures, who showed increased anxiety, depression, and fatigue. Excessive daytime sleepiness and fatigue improved after 3 months of treatment with methylphenidate hydrochloride prolonged-release tablets in combination with venlafaxine.