Department of Psychology, University of Bologna, Bologna, Italy.
Sleep Med. 2011 Aug;12(7):635-40. doi: 10.1016/j.sleep.2010.12.016. Epub 2011 Jun 24.
OBJECTIVE: The study aimed to examine the temporal distribution of episodes of REM sleep behaviour disorder (RBD) over the night and their motor and polysomnographic (PSG) characteristics in patients with narcolepsy-cataplexy (NC). METHODS: Full-night video-PSG recordings of a continuous series of 37 drug-naïve NC patients with clinically-documented RBD were examined to detect the occurrences of RBD episodes (disclosed in 27 patients) and to classify their related PSG and motor behaviour features. RESULTS: RBD episodes occurred with comparable frequency in REM sleep periods of the first and second halves of the night, regardless of the length of REM periods, patients' age or disease duration. Vocalisations and pantomimes occurred in comparable proportions of RBD episodes in the two halves of the night, while aggressive-violent movements were significantly more frequent in RBD episodes of the second half of the night. No sleep parameter significantly differed in patients with RBD occurring in the first/second/neither half of the night. CONCLUSIONS: RBD episodes (a) are not an every night phenomenon in NC patients with clinically documented RBD, regardless of their age or disease duration; (b) can occur in any period of REM sleep, regardless of length; and (c) display less violent-aggressive motor features when they occur in the first half of the night. Multi-night studies with dream-report collection may disclose whether this overnight variation in the violent-aggressive features in RBD episodes of NC patients is associated with a time-of-night-related variation in dream content.
目的:本研究旨在探讨发作性睡病伴猝倒患者(NC)夜间 REM 睡眠行为障碍(RBD)发作的时间分布及其运动和多导睡眠图(PSG)特征。
方法:对 37 例未经药物治疗的、临床确诊为 RBD 的 NC 患者进行整夜视频 PSG 记录,以检测 RBD 发作(27 例患者中发现),并对其相关 PSG 和运动行为特征进行分类。
结果:无论 REM 期长短、患者年龄或疾病持续时间如何,RBD 发作在夜间前、后半期 REM 睡眠中的发生频率相当。发声和模拟动作在夜间前、后半期 RBD 发作中的发生比例相当,而攻击性暴力动作在夜间后半期 RBD 发作中更为频繁。在 RBD 发作于夜间前、后半期或均未发生的患者中,无任何睡眠参数存在显著差异。
结论:(a)在有临床确诊 RBD 的 NC 患者中,RBD 发作并非每晚都会发生,这与患者的年龄或疾病持续时间无关;(b)无论 REM 期长短如何,RBD 发作均可发生在 REM 睡眠的任何时期;(c)当 RBD 发作发生在夜间前半段时,其运动特征的攻击性和暴力性较弱。通过进行多夜研究并收集梦境报告,可能会揭示 NC 患者 RBD 发作中这些夜间攻击性和暴力性特征的变化是否与梦境内容与时相关的变化有关。
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