Blaivas Allen J, Patel Rajeshri, Hom David, Antigua Kenneth, Ashtyani Hormoz
Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, 385 Tremont Avenue, East Orange, NJ 07018, USA.
Sleep Med. 2007 Mar;8(2):156-9. doi: 10.1016/j.sleep.2006.06.011. Epub 2007 Jan 18.
The qualitative presence of microsleep during the multiple sleep latency test (MSLT) has been shown to correlate with an increased incidence of subjective complaints of sleepiness, tiredness, accidents/near accidents, and gap driving. However, there is no data on how to quantify microsleep and effectively incorporate it as a diagnostic tool in the measurement of sleepiness. The purpose of this study was to integrate microsleep with the MSLT score and determine if it improved the correlation between the MSLT and symptomatic sleepiness.
The charts of 54 patients who had an MSLT score of greater than 5min and the presence of microsleep on at least one nap were reviewed. If microsleep was present in a given nap it was used as a surrogate for sleep onset. This MSLT plus microsleep score (MSL-M) was then averaged into the total sleep latency and compared to the MSLT score to determine if it improves correlation with the Epworth sleepiness scale (ESS). A microsleep nap percentage (MNP) was also obtained and correlated with ESS to determine if a better association could be derived.
Using the Spearman correlation the MSL-M improved the correlation with the ESS when compared to MSLT (r=0.106 versus r=0.063), but the results were not statistically significant. Of note, both the MSLT and MSL-M were only weakly correlated to the ESS. The MNP also did not have a good correlation with ESS (r=-0.099).
The addition of microsleep onset to the MSLT score as a quantitative assessment tool failed to significantly enhance the correlation between subjective and objective accounts of sleepiness, beyond the improvement seen in the MSLT value by the simple presence of microsleep alone.
多次睡眠潜伏期试验（MSLT）期间微睡眠的定性存在已被证明与嗜睡、疲劳、事故/险些发生事故以及间隙性驾驶等主观症状的发生率增加相关。然而，关于如何量化微睡眠并将其有效地作为嗜睡测量的诊断工具，目前尚无相关数据。本研究的目的是将微睡眠与MSLT评分相结合，并确定其是否能改善MSLT与症状性嗜睡之间的相关性。
回顾了54例MSLT评分大于5分钟且至少有一次小睡时存在微睡眠的患者的病历。如果在某次小睡中出现微睡眠，则将其用作睡眠开始的替代指标。然后将该MSLT加微睡眠评分（MSL-M）平均计入总睡眠潜伏期，并与MSLT评分进行比较，以确定其是否能改善与爱泼华嗜睡量表（ESS）的相关性。还获得了微睡眠小睡百分比（MNP），并将其与ESS进行相关性分析，以确定是否能得出更好的关联。
使用Spearman相关性分析，与MSLT相比，MSL-M改善了与ESS的相关性（r = 0.106对r = 0.063），但结果无统计学意义。值得注意的是，MSLT和MSL-M与ESS均仅呈弱相关。MNP与ESS也没有良好的相关性（r = -0.099）。
将微睡眠开始作为一种定量评估工具添加到MSLT评分中，未能显著增强主观和客观嗜睡描述之间的相关性，超出了仅因微睡眠的存在而使MSLT值得到的改善。
