Wayne State University School of Medicine, Detroit, Michigan, USA.
Pain Pract. 2010 Jul-Aug;10(4):294-300. doi: 10.1111/j.1533-2500.2009.00352.x. Epub 2010 Mar 2.
This study characterizes findings on sleep testing and Human Leukocyte Antigen (HLA) markers in a group of patients with fibromyalgia (FM) and chronic fatigue syndrome (CFS). One hundred eighteen patients seen in a general neurology practice over 5 years meeting standard clinical criteria for FM or CFS were analyzed retrospectively. Cases of untreated sleep apnea or restless legs syndrome were excluded prior to inclusion in this study. Ninety-two patients had multiple sleep latency testing (MSLT). Seventy-three (80%) were abnormal by standard criteria. Of 57 females having positive MSLTs, 22 (39%) had one or more periods of sleep onset rapid eye movement (SOREM), and 5 of 16 (31%) males with positive MSLTs had one or more SOREM. Highly fragmented sleep, as previously described in FM, was seen but not analyzed quantitatively. HLA DQB1*0602 was obtained in 74 patients, and positive in 32 (43%), P < 0.0001 compared with published values in 228 populations. In our patients, who presented with neuromuscular fatigue or generalized pain, we found a sleep disorder characterized by objective hypersomnia. Some patients had characteristics of narcolepsy. Objective assessment by sleep studies can assist the diagnostic process, aid future research, and provide rationale for treatment.
本研究描述了一组纤维肌痛（FM）和慢性疲劳综合征（CFS）患者的睡眠测试和人类白细胞抗原（HLA）标志物的发现。对 5 年内在一家普通神经病学诊所就诊的符合 FM 或 CFS 标准临床标准的 118 例患者进行回顾性分析。在将这些患者纳入本研究之前，排除了未经治疗的睡眠呼吸暂停或不宁腿综合征。92 例患者接受了多次睡眠潜伏期测试（MSLT）。73 例（80%）按标准标准异常。在 57 名阳性 MSLT 的女性中，有 22 名（39%）有一次或多次睡眠开始快速眼动（SOREM），16 名阳性 MSLT 的男性中有 5 名（31%）有一次或多次 SOREM。正如在 FM 中所描述的那样，存在高度碎片化的睡眠，但未进行定量分析。在 74 例患者中获得了 HLA DQB1*0602，阳性率为 32 例（43%），与 228 例人群中的公布值相比，P<0.0001。在我们的患者中，表现为神经肌肉疲劳或全身性疼痛，我们发现了一种以客观嗜睡为特征的睡眠障碍。一些患者具有嗜睡症的特征。通过睡眠研究进行客观评估可以辅助诊断过程，有助于未来的研究，并为治疗提供依据。
