Samushiya M A, Ragimova A A, Ivolgin A F, Avseitseva T Yu, Smolentseva I G, Ivannikova E I
Central State Medical Academy of Administrative Directorate of the President of the Russian Federation, Moscow, Russia.
Vishnevsky 3-rd Central Military Clinical Hospital, Krasnogorsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(12):25-29. doi: 10.17116/jnevro202012012125.
To clarify the structure of sleep disorders in cervical dystonia and assess their relationship with anxiety and depressive disorders, as well as the impact on quality of life.
Twenty-five patients diagnosed with cervical dystonia (CD) were examined using neurological and psychometric methods (HADS, HAM-D, TAS, SCID-II, SF-36, PSQI). Polysomnographic study was performed using a Somnolab 2 system (Weinmann, Germany).
Nineteen patients (76%) from the total sample showed increases in anxiety and depression. Sleep disorders were detected in all patients diagnosed with anxiety and depressive disorders. According to questionnaires, anxiety, depression, and sleep disturbances were significantly correlated with patients' quality of life. The most common sleep disorders were intrasomic disorders (waking up during sleep) (=19; 76%), less common were presomnic (=8; 32%) and postsomnic (=11; 44%). Motor symptoms caused sleep disturbances only in 10 patients (40%). The specific features of sleep disorders in patients with CD detected by polysomnography are a decrease in the representation of delta-sleep, along with an increase in the phase of REM sleep, compared to physiological normal values.
Sleep disturbances (mainly frequent waking during sleep) are widely represented in patients with cervical dystonia, are comorbid to anxiety and depressive disorders and significantly correlate with the poorer quality of life.
阐明颈部肌张力障碍患者睡眠障碍的结构，评估其与焦虑症和抑郁症的关系，以及对生活质量的影响。
采用神经学和心理测量方法（医院焦虑抑郁量表、汉密尔顿抑郁量表、多伦多述情障碍量表、精神障碍诊断与统计手册第二版、简明健康状况调查量表、匹兹堡睡眠质量指数）对25例诊断为颈部肌张力障碍（CD）的患者进行检查。使用Somnolab 2系统（德国韦恩曼公司）进行多导睡眠图研究。
总样本中的19例患者（76%）出现焦虑和抑郁加重。在所有诊断为焦虑症和抑郁症的患者中均检测到睡眠障碍。根据问卷调查，焦虑、抑郁和睡眠障碍与患者的生活质量显著相关。最常见的睡眠障碍是睡眠中觉醒（入睡障碍）（n = 19；76%），较少见的是睡前障碍（n = 8；32%）和睡后障碍（n = 11；44%）。只有10例患者（40%）的运动症状导致睡眠障碍。多导睡眠图检测到的CD患者睡眠障碍的具体特征是与生理正常值相比，慢波睡眠的比例降低，快速眼动睡眠期增加。
睡眠障碍（主要是睡眠中频繁觉醒）在颈部肌张力障碍患者中广泛存在，与焦虑症和抑郁症共病，且与较差的生活质量显著相关。
