Le Bon Olivier, Minner Pierre, Van Moorsel Cédric, Hoffmann Guy, Gallego Soledad, Lambrecht Luc, Pelc Isidore, Linkowski Paul
Department of Psychiatry, CHU Brugmann S48, Place Van Gehuchten 4, 1020 Brussels, Belgium.
Psychiatry Res. 2003 Sep 30;120(2):191-9. doi: 10.1016/s0165-1781(03)00185-9.
Since the magnitude of the first-night effect has been shown to be a function of medical conditions and of settings in which polysomnographies are performed, it is essential to evaluate the habituation phenomenon in each case in order to determine the optimal recording methodology. A first-night effect was evidenced in certain cases of chronic fatigue syndrome, but not in others. To clarify this issue, a large group of patients with chronic fatigue syndrome who had no primary sleep disorders were selected and recorded for two consecutive nights in a hospital sleep unit. Several parameters, frequently associated with the first-night effect, were found to be influenced by the recording methodology: Total Sleep Time, Sleep Efficiency, Sleep Efficiency minus Sleep Onset, Sleep Onset Latency, Wake Time, Slow Wave Sleep, Rapid Eye Movement Sleep, Rapid Eye Movement Sleep Latency and Number of Sleep Cycles. Bland and Altman plots determined that the difference scores between the nights included a systematic bias linked to the order of recordings (first-night effect). Factorial analysis grouped the difference scores into three factors. No significant difference was observed between patients with generalized anxiety comorbidity and those with no psychiatric comorbidity, or between those with and without psychiatric comorbidity. Chronic fatigue syndrome must thus be added on the list of conditions where a clinically significant habituation effect takes place.
由于首夜效应的大小已被证明是医学状况以及进行多导睡眠图检查的环境的函数，因此在每种情况下评估适应现象以确定最佳记录方法至关重要。在某些慢性疲劳综合征病例中证实存在首夜效应，但在其他病例中则未发现。为了阐明这个问题，选择了一大组没有原发性睡眠障碍的慢性疲劳综合征患者，并在医院睡眠单元连续记录两晚。发现几个经常与首夜效应相关的参数受记录方法的影响：总睡眠时间、睡眠效率、睡眠效率减去入睡时间、入睡潜伏期、觉醒时间、慢波睡眠、快速眼动睡眠、快速眼动睡眠潜伏期和睡眠周期数。布兰德-奥特曼图确定两晚之间的差异分数存在与记录顺序相关的系统偏差（首夜效应）。因子分析将差异分数分为三个因素。合并广泛性焦虑症的患者与未合并精神疾病的患者之间，以及合并和未合并精神疾病的患者之间均未观察到显著差异。因此，慢性疲劳综合征必须列入发生具有临床意义的适应效应的病症清单中。
