Department of Neurology, Innsbruck Medical University, Austria.
J Sleep Res. 2011 Dec;20(4):514-21. doi: 10.1111/j.1365-2869.2011.00906.x. Epub 2011 Jan 25.
Motor events during sleep can be frequently observed in patients with narcolepsy-cataplexy. We hypothesized that increased motor events and related arousals contribute to sleep fragmentation in this disease. We aimed to perform a detailed whole-night video-polysomnographic analysis of all motor events during non-rapid eye movement and rapid eye movement sleep in a group of narcolepsy-cataplexy patients and matched controls, and to assess the association with arousals. Video-polysomnographic registrations of six narcolepsy-cataplexy patients and six sex- and age-matched controls were analysed. Each motor event in the video was classified according to topography, number of involved body parts, duration and its association with arousals. The mean motor activity index was 59.9 ± 23.0 h(-1) in patients with narcolepsy-cataplexy compared with 15.4 ± 9.2 h(-1) in controls (P = 0.004). Distribution of motor events was similar in non-rapid eye movement and rapid eye movement sleep in the patient group (P = 0.219). In narcolepsy-cataplexy, motor events involved significantly more body parts (≥ 2 body regions: 38.2 ± 15.6 versus 14.9 ± 10.0; P = 0.011). In addition, the proportion of motor events lasting longer than 1 s was higher in patients than controls (88% versus 44.4%; P < 0.001). Both total and motor activity-related arousal indices were increased in narcolepsy-cataplexy (total arousal index: 21.6 ± 9.0 versus 8.7 ± 3.5; P = 0.004; motor activity-related arousal index: 17.6 ± 9.8 versus 5.9 ± 2.3; P = 0.002). Motor activity and motor activity-related arousal indices are increased in both non-rapid eye movement and rapid eye movement sleep in narcolepsy-cataplexy compared with controls. This supports the concept of a general sleep motor dysregulation in narcolepsy-cataplexy, which potentially contributes to or even underlies sleep fragmentation in this disease.
在发作性睡病-猝倒症患者中，常可观察到睡眠中的运动事件。我们推测，在这种疾病中，运动事件的增加以及相关的觉醒可能导致睡眠碎片化。我们旨在对一组发作性睡病-猝倒症患者和匹配的对照组进行整夜视频多导睡眠图分析，以评估非快速眼动和快速眼动睡眠期间的所有运动事件，并评估与觉醒的关联。分析了 6 例发作性睡病-猝倒症患者和 6 例性别和年龄匹配的对照组的视频多导睡眠图记录。根据部位、涉及的身体部位数量、持续时间及其与觉醒的关系，对视频中的每个运动事件进行分类。发作性睡病-猝倒症患者的平均运动活动指数为 59.9±23.0 h-1，而对照组为 15.4±9.2 h-1（P=0.004）。在患者组中，非快速眼动和快速眼动睡眠中的运动事件分布相似（P=0.219）。在发作性睡病-猝倒症中，运动事件涉及的身体部位明显更多（≥2 个身体区域：38.2±15.6 与 14.9±10.0；P=0.011）。此外，持续时间超过 1 s 的运动事件比例在患者中高于对照组（88%与 44.4%；P<0.001）。发作性睡病-猝倒症的总觉醒和与运动活动相关的觉醒指数均增加（总觉醒指数：21.6±9.0 与 8.7±3.5；P=0.004；与运动活动相关的觉醒指数：17.6±9.8 与 5.9±2.3；P=0.002）。与对照组相比，非快速眼动和快速眼动睡眠中的运动活动和与运动活动相关的觉醒指数在发作性睡病-猝倒症中均增加。这支持发作性睡病-猝倒症中存在一般睡眠运动失调的概念，这可能导致或甚至是这种疾病中睡眠碎片化的基础。
