Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
Sleep Med. 2020 May;69:78-84. doi: 10.1016/j.sleep.2019.12.026. Epub 2020 Jan 10.
Sleep state misperception is common in various sleep disorders, especially in chronic insomnia with a prevalence ranging between 9-50%. Most prior studies used nocturnal polysomnography (PSG) for the identification of sleep state misperception during nighttime. Our objective was to assess sleep state misperception during daytime in people with sleep disorders with excessive daytime sleepiness (EDS).
In this prospective observational study, we assessed the occurrence of, and factors influencing sleep state misperception in consecutive patients undergoing a routine multiple sleep latency test (MSLT) in a tertiary sleep-wake centre included between 2014 and 2017. Mixed models were applied to assess the influence of patients' clinical data on sleep state perception.
People with narcolepsy type 1 (NT1, n = 33) and type 2 (NT2, n = 14), idiopathic hypersomnia (IH, n = 56), obstructive sleep apnea (OSA, n = 31) and insufficient sleep syndrome (ISS, n = 31) were included. The prevalence of both classical and reverse sleep state misperception did not differ between the sleep disorders (mean 25%, range 8-37%) after correction for sleep stage, sleep onset latency and age. Longer sleep onset latency and reaching only non-rapid eye movement (REM) sleep stage 1 were significant predictors for classical sleep state misperception.
Sleep state misperception is common in people with NT1 and NT2, IH, OSA, and ISS. Classical sleep state misperception is more frequent in patients with longer sleep onset latencies who only reach non-REM sleep stage 1 during a nap.
睡眠状态感知错误在各种睡眠障碍中较为常见，在慢性失眠症中更为常见，患病率在 9%至 50%之间。大多数先前的研究使用夜间多导睡眠图（PSG）来识别夜间的睡眠状态感知错误。我们的目的是评估白天患有嗜睡症（EDS）的睡眠障碍患者的睡眠状态感知错误。
在这项前瞻性观察研究中，我们评估了 2014 年至 2017 年间在一家三级睡眠-觉醒中心进行常规多次睡眠潜伏期测试（MSLT）的连续患者中睡眠状态感知错误的发生情况及其影响因素。混合模型用于评估患者临床数据对睡眠状态感知的影响。
纳入了 33 例 1 型发作性睡病（NT1）、14 例 2 型发作性睡病（NT2）、56 例特发性嗜睡症（IH）、31 例阻塞性睡眠呼吸暂停（OSA）和 31 例睡眠不足综合征（ISS）患者。校正睡眠阶段、睡眠潜伏期和年龄后，睡眠障碍患者的经典和反向睡眠状态感知错误的患病率无差异（平均 25%，范围 8%至 37%）。较长的睡眠潜伏期和仅达到非快速眼动（REM）睡眠 1 期是经典睡眠状态感知错误的显著预测因素。
NT1 和 NT2、IH、OSA 和 ISS 患者中睡眠状态感知错误较为常见。在白天打盹时仅达到非 REM 睡眠 1 期且睡眠潜伏期较长的患者中，经典睡眠状态感知错误更为常见。
