Bliwise Donald L, Rye David B, Dihenia Bhupesh, Gurecki Paul
Sleep Disorders Center, Department of Neurology, Emory University Medical School, Wesley Woods Geriatric Hospital, Atlanta, Georgia 30322, USA.
J Geriatr Psychiatry Neurol. 2002 Summer;15(2):61-7. doi: 10.1177/089198870201500202.
Deficits in daytime alertness in the elderly may reflect, in part, deterioration of the critical neural systems modulating circadian control of sleep and wakefulness. In this study, 47 patients with subcortical stroke (n = 9), Alzheimer's disease (n = 6), and parkinsonism (n = 32) underwent a 24-hour in-laboratory evaluation consisting of overnight polysomnography and next-day evaluation of daytime sleep tendency with the Multiple Sleep Latency Test. Patients with stroke were significantly sleepier during the daytime relative to the Parkinson's and Alzheimer's disease patients. Nocturnal sleep parameters did not account for these differences. In the stroke patients, some infarcts occurred in the vasculature, impacting blood supply to the hypothalamus. We interpret these effects as representing functional interruptions of the suprachiasmatic nucleus (SCN). These results are also compatible with a wake-promoting function of the human SCN.
老年人白天警觉性下降可能部分反映了调节睡眠和觉醒昼夜节律控制的关键神经系统的退化。在本研究中，47例患有皮质下中风（n = 9）、阿尔茨海默病（n = 6）和帕金森症（n = 32）的患者接受了一项为期24小时的实验室评估，包括夜间多导睡眠图监测以及次日通过多次睡眠潜伏期测试评估白天的睡眠倾向。与帕金森病和阿尔茨海默病患者相比，中风患者白天明显更困倦。夜间睡眠参数并不能解释这些差异。在中风患者中，一些梗死发生在脉管系统，影响了下丘脑的血液供应。我们将这些影响解释为视交叉上核（SCN）功能中断。这些结果也与人类SCN的促觉醒功能相符。
