Fitzpatrick M F, Engleman H, Whyte K F, Deary I J, Shapiro C M, Douglas N J
Respiratory Medicine Unit, City Hospital, Edinburgh.
Thorax. 1991 Aug;46(8):569-73. doi: 10.1136/thx.46.8.569.
Most patients with asthma waken with nocturnal asthma from time to time. To assess morbidity in patients with nocturnal asthma nocturnal sleep quality, daytime sleepiness, and daytime cognitive performance were measured prospectively in 12 patients with nocturnal asthma (median age 43 years) and 12 age and intellect matched normal subjects. The median (range) percentage overnight fall in peak expiratory flow rate (PEF) was 22 (15 to 50) in the patients with nocturnal asthma and 4 (-4 to 7) in the normal subjects. The patients with asthma had poorer average scores for subjective sleep quality than the normal subjects (median paired difference 1.1 (95% confidence limits 0.1, 2.3)). Objective overnight sleep quality was also worse in the asthmatic patients, who spent more time awake at night (median difference 51 (95% CL 8.1, 74) minutes), had a longer sleep onset latency (12 (10, 30) minutes), and tended to have less stage 4 (deep) sleep (-33 (-58, 4) minutes). Daytime cognitive performance was worse in the patients with nocturnal asthma, who took a longer time to complete the trail making tests (median difference 62 (22, 75) seconds) and achieved a lower score on the paced serial addition tests (-10 (-24, -3)). Mean daytime sleep latency did not differ significantly between the two groups (2 (-3, 7) minutes). It is concluded that hospital outpatients with stable nocturnal asthma have impaired sleep quality and daytime cognitive performance even when having their usual maintenance asthma treatment.
大多数哮喘患者偶尔会因夜间哮喘而醒来。为评估夜间哮喘患者的发病情况，对12例夜间哮喘患者（中位年龄43岁）及12名年龄和智力匹配的正常受试者进行前瞻性测量，内容包括夜间睡眠质量、日间嗜睡程度和日间认知能力。夜间哮喘患者呼气峰值流速（PEF）的夜间下降百分比中位数（范围）为22%（15%至50%），正常受试者为4%（-4%至7%）。哮喘患者主观睡眠质量的平均得分低于正常受试者（中位配对差值为1.1（95%置信区间0.1, 2.3））。哮喘患者的客观夜间睡眠质量也较差，他们夜间清醒时间更长（中位差值为51（95%置信区间8.1, 74）分钟），入睡潜伏期更长（12（10, 30）分钟），且慢波睡眠（深度睡眠）往往更少（-33（-58, 4）分钟）。夜间哮喘患者的日间认知能力较差，他们完成连线测试所需时间更长（中位差值为62（22, 75）秒），在数字划销测试中的得分更低（-10（-24, -3））。两组间的平均日间睡眠潜伏期无显著差异（2（-3, 7）分钟）。结论是，即使接受常规维持性哮喘治疗，门诊稳定型夜间哮喘患者的睡眠质量和日间认知能力仍会受损。
