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日间嗜睡:不仅仅是阻塞性睡眠呼吸暂停(OSA)。

Daytime sleepiness: more than just Obstructive Sleep Apnea (OSA).

作者信息

Ferini-Strambi Luigi, Sforza Marco, Poletti Mattia, Giarrusso Federica, Galbiati Andrea

机构信息

IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences and Università Vita-Salute San Raffaele, Milan, Italy.

出版信息

Med Lav. 2017 Aug 28;108(4):260-266. doi: 10.23749/mdl.v108i4.6497.

Abstract

Excessive Daytime Sleepiness (EDS) is a common condition with a significant impact on quality of life and general health. A mild form of sleepiness can be associated with reduced reactivity and modest distractibility symptoms, but more severe symptomatic forms are characterized by an overwhelming and uncontrollable need to sleep, causing sudden sleep attacks, amnesia and automatic behaviors. The prevalence in the general population is between 10 and 25%. Furthermore, EDS has been considered a core symptom of obstructive sleep apnea (OSA), as well as being the main symptom of primary hypersomnias such as narcolepsy types 1 and 2, and idiopathic hypersomnia. Moreover, it can be considered secondary to other sleep disorders (Restless Legs Syndrome, Chronic insomnia, Periodic Limb Movements), psychiatric conditions (Depression, Bipolar Disorder) or a consequence of the intake/abuse of drugs and/or substances. An accurate medical history cannot be sufficient for the differential diagnosis, therefore instrumental recordings by means of polysomnography and the Multiple Sleep Latency Test (MSLT) are mandatory for a correct diagnosis and treatment of the underlying cause of EDS.

摘要

日间过度嗜睡(EDS)是一种常见病症,对生活质量和总体健康有重大影响。轻度嗜睡可能与反应性降低和适度的注意力分散症状有关,但更严重的症状形式表现为强烈且无法控制的睡眠需求,导致突然发作性睡眠、失忆和自动行为。普通人群中的患病率在10%至25%之间。此外,EDS被认为是阻塞性睡眠呼吸暂停(OSA)的核心症状,也是发作性睡病1型和2型以及特发性嗜睡症等原发性睡眠过多症的主要症状。此外,它可被认为是继发于其他睡眠障碍(不宁腿综合征、慢性失眠、周期性肢体运动)、精神疾病(抑郁症、双相情感障碍)或药物和/或物质摄入/滥用的结果。准确的病史不足以进行鉴别诊断,因此通过多导睡眠图和多次睡眠潜伏期试验(MSLT)进行仪器记录对于正确诊断和治疗EDS的潜在病因是必不可少的。

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