目的:白天过度嗜睡(EDS)早被报道为小儿嗜睡患者中最致残的症状。然而,缺乏研究来检查儿童嗜睡患者EDS的昼夜节律。因此,目的探讨儿童发作性睡病患者EDS的昼夜节律。
方法:我们确定了50名儿童发作性嗜睡症患者(男性36名,女性14名,平均年龄13.68±2.75岁)。通过访谈和相关问卷(儿童抑郁量表[CDI]和儿科生活质量量表[PedsQL])收集数据。
结果:一天中不同时间间隔的睡眠发作频率差异很大,早上的频率较高(p<.001)。上午和下午的睡眠发作次数与上课障碍程度和担心嗜睡的严重程度显着相关,斯皮尔曼相关系数为.289至.496(p<.05)。晨睡占主导的PedsQL和CDI总分差异显著,下午嗜睡占主导地位,和晚上嗜睡显性群体(p=.042,p=.040)。嗜睡患者嗜睡的严重程度评分有两个峰值,其中一个发生在16:00,其他高峰发生在11:00左右。
结论:这些结果表明,在治疗策略中,应根据儿童嗜睡患者嗜睡的昼夜节律进行改变。此外,调节褪黑激素的分泌可能是将来缓解嗜睡的有希望的治疗方法。
Excessive daytime sleepiness (EDS) has been far back reported as the most disabling symptom in the pediatric narcoleptic patients. However, there is a lack of studies to examine the circadian rhythms of EDS in pediatric narcoleptic population. Therefore, we aim to investigate the circadian rhythm of EDS in pediatric narcolepsy patients.
We identified 50 pediatric narcoleptic patients (36 males and 14 females, mean age 13.68 ± 2.75 years). Data were collected through interviews and the relevant questionnaires (children depression inventory [CDI] and the pediatric quality of life inventory [PedsQL]).
The frequencies of sleep attacks during different intervals of the day differed significantly, with higher frequency in the morning (p < .001). The times of sleep attacks in the morning and in the afternoon were significantly associated with the degree of impairment on class and the severity of worry about sleepiness, with spearman correlation coefficient ranging from .289 to .496 (p < .05). The total scores of PedsQL and CDI differed significantly among morning sleepiness dominant, afternoon sleepiness dominant, and evening sleepiness dominant groups (p = .042, p = .040). The severity scores of the narcoleptic patients\' sleepiness had two peaks, one of which occurred at 16:00, and the other peaks occurred at about 11:00.
These results suggest that changes based on the circadian rhythm of sleepiness of the pediatric narcoleptic patients should be made in the treatment strategy. In addition, regulating the secretion of melatonin could serve as a promising treatment to relieve sleepiness in the future.