Zhang Ye, Ren Rong, Yang Linghui, Zhang Haipeng, Shi Yuan, Sanford Larry D, Tang Xiangdong
Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Sleep Med Rev. 2021 Aug;58:101488. doi: 10.1016/j.smrv.2021.101488. Epub 2021 Apr 5.
Polysomnographic studies have been conducted to explore nighttime sleep features in narcolepsy, but their relationship to narcolepsy is still imperfectly understood. We conducted a systematic review of the literature exploring polysomnographic differences between narcolepsy patients and healthy controls (HCs) in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycINFO. 108 studies were identified for this review, 105 of which were used for meta-analysis. Meta-analyses revealed significant reductions in sleep latency, sleep efficiency, slow wave sleep percentage, rapid eye movement sleep (REM) latency, cyclic alternating pattern rate, and increases in total sleep time, wake time after sleep onset (WASO), awakening numbers (AWN) per hour, stage shift (SS) per hour, N1 percentage, apnea hypopnea index, and periodic limb movement index in narcolepsy patients compared with HCs. Furthermore, narcolepsy type 1 patients showed more disturbed nighttime sleep compared with narcolepsy type 2 patients. Children and adolescent narcolepsy patients show increased WASO, AWN, and SS compared with adult patients. Macro- and micro-structurally, our study suggests that narcolepsy patients have poor nighttime sleep. Sex, age, body mass index, disease duration, disease type, medication status, and adaptation night are demographic, clinical and methodological factors that contribute to heterogeneity between studies.
多导睡眠图研究已开展以探索发作性睡病的夜间睡眠特征，但它们与发作性睡病之间的关系仍未被完全理解。我们对EMBASE、MEDLINE、所有循证医学数据库、护理学与健康领域数据库以及心理学文摘数据库中探索发作性睡病患者与健康对照（HCs）之间多导睡眠图差异的文献进行了系统综述。本次综述共识别出108项研究，其中105项用于荟萃分析。荟萃分析显示，与健康对照相比，发作性睡病患者的睡眠潜伏期、睡眠效率、慢波睡眠百分比、快速眼动睡眠（REM）潜伏期、周期性交替模式率显著降低，而总睡眠时间、睡眠起始后觉醒时间（WASO）、每小时觉醒次数（AWN）、每小时睡眠阶段转换次数（SS）、N1期百分比、呼吸暂停低通气指数和周期性肢体运动指数增加。此外，与2型发作性睡病患者相比，1型发作性睡病患者夜间睡眠更紊乱。儿童和青少年发作性睡病患者与成年患者相比，WASO、AWN和SS增加。从宏观和微观结构上看，我们的研究表明发作性睡病患者夜间睡眠质量较差。性别、年龄、体重指数、病程、疾病类型、用药情况和适应夜是导致研究间异质性的人口统计学、临床和方法学因素。
