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猝倒症性睡眠呼吸暂停在伴有猝倒的发作性睡病患者中使用苯海拉明治疗。

Catathrenia under sodium oxybate in narcolepsy with cataplexy.

机构信息

Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy.

出版信息

Sleep Breath. 2012 Jun;16(2):427-34. doi: 10.1007/s11325-011-0520-2. Epub 2011 Apr 12.

Abstract

PURPOSE

This study aims to report on catathrenia occurring in narcolepsy with cataplexy (NC) patients under sodium oxybate (SO) treatment. Catathrenia is a parasomnia characterized by groaning and an abnormal respiratory pattern during sleep.

METHODS

Fifty-one patients with NC and starting SO therapy underwent a baseline overnight polysomnography (PSG) to detect any sleep-related breathing disorders (SRBD). To avoid risks due to a possible central respiratory control depression by SO, all patients with concomitant obstructive sleep apnea (OSA) were treated with a nasal continuous positive airway pressure (nCPAP) device. After 2 months of treatment with SO, all patients underwent a follow-up overnight PSG to investigate possible newly occurring SRBD. They also underwent a semi-structured clinical interview to monitor other potential SO side effects.

RESULTS

At baseline, four out of 51 patients showed simple snoring, and eight, mild to severe OSA. After a titration PSG night, patients with OSA received a nCPAP device. After 2 months of SO treatment, 28 patients (54.9%) showed SO-related side effects, including SRBD in 11 (21.6%). The follow-up PSG showed a respiratory pattern characteristic of catathrenia in seven patients (13.7%) as a newly observed and possibly benign SO side effect, and ruled out a worsening of OSA.

CONCLUSIONS

Catathrenia should be considered a possible side effect in NC patients under SO treatment and should be accurately identified to prevent unnecessary SO withdrawal.

摘要

目的

本研究旨在报告接受羟丁酸钠(SO)治疗的发作性睡病伴猝倒症(NC)患者出现的睡眠呼吸暂停低通气综合征(SAHS)。睡眠呼吸暂停低通气综合征是一种以睡眠时呻吟和异常呼吸模式为特征的睡眠障碍。

方法

51 例 NC 患者开始接受 SO 治疗,行基线整夜多导睡眠图(PSG)以检测任何与睡眠相关的呼吸障碍(SRBD)。为避免 SO 可能引起的中枢性呼吸控制抑制的风险,所有合并阻塞性睡眠呼吸暂停(OSA)的患者均采用持续气道正压通气(nCPAP)治疗。SO 治疗 2 个月后,所有患者均行随访整夜 PSG 以调查可能新出现的 SRBD。他们还接受了半结构化临床访谈,以监测其他潜在的 SO 副作用。

结果

基线时,51 例患者中有 4 例单纯打鼾,8 例有轻至重度 OSA。在滴定 PSG 夜后,OSA 患者接受了 nCPAP 装置。SO 治疗 2 个月后,28 例(54.9%)患者出现 SO 相关副作用,包括 11 例(21.6%) SAHS。随访 PSG 显示 7 例患者(13.7%)出现了特征性的睡眠呼吸暂停低通气综合征呼吸模式,这可能是一种新出现的良性 SO 副作用,排除了 OSA 恶化的可能。

结论

在接受 SO 治疗的 NC 患者中,应考虑将睡眠呼吸暂停低通气综合征作为一种可能的副作用,并应准确识别,以防止不必要的 SO 停药。

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