Sondheimer J M, Hoddes E
Section of Pediatric Gastroenterology and Nutrition, University of Colorado School of Medicine, Denver.
Gastroenterology. 1991 Oct;101(4):1007-11. doi: 10.1016/0016-5085(91)90727-3.
Twenty-four infants, 3-35 months of age, with histories of apnea or chronic lung disease underwent nighttime polysomnography and esophageal pH monitoring. Fifteen infants had pathological levels of gastroesophageal reflux on esophageal pH monitoring, and 9 had normal study results (symptomatic controls). Partition of sleep stages, sleep efficiency, and frequency of arousals to electroencephalographic stage 0 were the same in both groups. During sleeping reflux episodes, defined as reflux starting during sleep stages 1-5 or reflux episodes consisting of greater than 50% of sleep stages 1-5, there was a 50% decrease in the amount of stage 0 electroencephalogram pattern compared with nonreflux sleep, and a compensatory increase in the non-rapid eye movement sleep stages. Reflux onsets in patients with pathological reflux were evenly divided between stages 0, 1/2, and 5. Onset of reflux occurred rarely during sleep stages 3 and 4. Slight body movement accompanied the onset of 62.5% of sleep reflux episodes in symptomatic controls and 64.7% in patients with pathological gastroesophageal reflux. Arousals to stage 0 electroencephalogram occurred with equal frequency in sleep reflux episodes of symptomatic controls and patients, and frequency did not increase over the observed value for nonreflux time. There were no differences between the sleep patterns of infants with and without pathological gastroesophageal reflux; nor were there decreases in arousals from sleep in infants with pathological reflux. However, reflux occurring during sleep in all infants studied was characterized by a significant decrease in stage 0 (waking) electroencephalogram.
24名年龄在3至35个月之间、有呼吸暂停或慢性肺病病史的婴儿接受了夜间多导睡眠图和食管pH监测。15名婴儿在食管pH监测中显示有胃食管反流的病理水平，9名婴儿的检查结果正常（症状对照）。两组的睡眠阶段划分、睡眠效率以及脑电图0期的觉醒频率相同。在睡眠反流发作期间，即定义为在睡眠1至5期开始的反流或由超过50%的睡眠1至5期组成的反流发作，与无反流睡眠相比，脑电图0期模式的量减少了50%，非快速眼动睡眠阶段有代偿性增加。病理性反流患者的反流发作在0期、1/2期和5期之间平均分布。在睡眠3期和4期很少发生反流发作。在有症状的对照组中，62.5%的睡眠反流发作开始时伴有轻微身体运动，在病理性胃食管反流患者中这一比例为64.7%。在有症状的对照组和患者的睡眠反流发作中，脑电图0期的觉醒频率相同，且频率未超过无反流时间的观察值。有或无病理性胃食管反流的婴儿的睡眠模式没有差异；病理性反流婴儿的睡眠觉醒也没有减少。然而，所有研究婴儿在睡眠期间发生的反流的特征是脑电图0期（清醒）显著减少。
