Hoppenbrouwers T
Department of Pediatrics, Womens Hospital LAC/USC Medical Center, University of Southern California School of Medicine.
J Clin Neurophysiol. 1992 Jan;9(1):32-47. doi: 10.1097/00004691-199201000-00004.
Sleep architecture derived from long-term polysomnographic recordings during the first year of life is characterized by clear developmental trends against a backdrop of variability. Variability is due to differences in state definitions and data collection and analysis strategies but probably also to an intrinsic characteristic of the maturing central nervous system (functional plasticity). Changes in sleep and wakefulness probably constitute nonspecific responses to a variety of stimuli. The variability has frustrated efforts to use specific features of sleep architecture for diagnostic or prognostic purposes. At present, polysomnographic studies of sleep architecture independent from EEG and cardiorespiratory studies are not indicated for diagnosing specific medical conditions or prognoses of good/adverse outcomes. For accurate interpretation for cardio-respiratory data, however, studies of sleep and wakefulness are indispensable. Furthermore, the study of neonatal seizures, in particular the coherence of state-defining variables or the evolution of sleep morphology, may benefit from attention to sleep architecture. Initial findings from some laboratories suggest that the very feature of excessive instability, which can be measured by repetitive long-term polysomnographic monitoring, signals a poor prognosis. In addition, fragmented sleep and the evolving interrelationship between ultradian and circadian rhythms may contain useful information that has yet to be mined. The advent of computer technologies can make the clinical laboratory into a setting where both research and clinical studies contribute to an elucidation of risk for sudden infant death syndrome and sequelae of neonatal seizures.
源自生命第一年长期多导睡眠图记录的睡眠结构，其特点是在变异性的背景下呈现出明显的发育趋势。变异性是由于状态定义以及数据收集与分析策略的差异所致，但也可能是成熟的中枢神经系统的一种内在特征（功能可塑性）。睡眠和觉醒的变化可能构成对多种刺激的非特异性反应。这种变异性阻碍了利用睡眠结构的特定特征进行诊断或预后判断的努力。目前，独立于脑电图和心肺研究的睡眠结构多导睡眠图研究并不适用于诊断特定的医学状况或判断良好/不良结局的预后。然而，对于准确解读心肺数据而言，睡眠和觉醒的研究是不可或缺的。此外，对新生儿癫痫的研究，特别是状态定义变量的连贯性或睡眠形态的演变，可能会因关注睡眠结构而受益。一些实验室的初步研究结果表明，可通过重复性长期多导睡眠图监测测量的过度不稳定性这一特征预示着预后不良。此外，碎片化睡眠以及超日节律和昼夜节律之间不断演变的相互关系可能包含尚未挖掘的有用信息。计算机技术的出现可使临床实验室成为一个研究和临床研究都有助于阐明婴儿猝死综合征风险和新生儿癫痫后遗症的场所。
