Nekrasova Julia, Kanarskii Mikhail, Yankevich Dmitrii, Shpichko Andrey, Borisov Ilya, Pradhan Pranil, Miroshnichenko Maria
Federal State Budget Scientific Institution, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia.
Federal State Budgetary Educational Institution of Higher Education, Moscow Aviation Institute (National Research University), Moscow, Russia.
Sleep Med X. 2020 Aug 28;2:100024. doi: 10.1016/j.sleepx.2020.100024. eCollection 2020 Dec.
Analysis of sleep patterns in patients with chronic disorders of consciousness attracts attention from the perspective of the diagnosis and prognosis of the disease as well as the treatment. Yet, the very existence of normal sleep in patients in a vegetative or minimally conscious state is still a matter of debate. This paper presents a retrospective analysis of overnight polysomnographic records of 40 patients with chronic disorders of consciousness aimed at the possibility of establishing the connection between the degree of impaired consciousness and the presence and organization of polysomnographic graphical elements, associated with stages of sleep in normal individuals. Specialized software based on expert system artificial intelligence was developed to calculate indices and parameters that characterize sleep. It was shown that a remarkably low percentage of patients have a rhythmic change in sleep patterns, what indicates the prevalence of violations of the Sleep-Wake cycle in a vegetative state and minimally conscious state. Sleep spindles were not found in records, however, the absence can originate from the limitations of polysomnographic method applied to patients with severe brain damage. A positive correlation between the rhythmic change of sleep patterns, better outcome and CRS-R scores was confirmed.
对慢性意识障碍患者睡眠模式的分析，从疾病的诊断、预后以及治疗等角度吸引了人们的关注。然而，处于植物人状态或最低意识状态的患者是否存在正常睡眠，仍是一个存在争议的问题。本文对40例慢性意识障碍患者的夜间多导睡眠图记录进行了回顾性分析，旨在确定意识障碍程度与多导睡眠图图形元素的存在及组织之间的联系，这些图形元素与正常个体的睡眠阶段相关。开发了基于专家系统人工智能的专业软件，以计算表征睡眠的指标和参数。结果表明，睡眠模式有节律变化的患者比例极低，这表明在植物人状态和最低意识状态下，睡眠-觉醒周期紊乱普遍存在。在记录中未发现睡眠纺锤波，不过，这种缺失可能源于应用于重度脑损伤患者的多导睡眠图方法的局限性。睡眠模式的节律变化、较好的预后与CRS-R评分之间的正相关关系得到了证实。
