Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France.
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
Sleep. 2023 Jul 11;46(7). doi: 10.1093/sleep/zsad056.
To establish whether the recent EEG and behavioral criteria of arousal disorders apply to sexsomnia.
EEG and behavioral markers upon N3 sleep interruptions in videopolysomnography were retrospectively compared in 24 participants with sexsomnia, 41 participants with arousals disorders, and 40 healthy controls. The specificity and sensitivity of previously suggested EEG and behavioral cutoffs for supporting arousal disorders diagnosis were measured in the sexsomnia vs. control groups.
Participants with sexsomnia and arousals disorders showed a higher N3 fragmentation index, slow/mixed N3 arousal index, and number of eye openings during N3 interruptions than healthy controls. Ten (41.7%) participants with sexsomnia (vs. one sleepwalker and no control) displayed an apparently sexual behavior (masturbation, sexual vocalization, pelvic thrusting, and hand within the pajama) during N3 arousal. An N3 sleep fragmentation index ≥6.8/h of N3 sleep and two or more N3 arousals associated with eye opening was 95% specific but poorly (46% and 42%) sensitive for diagnosing sexsomnia. An index of slow/mixed N3 arousals ≥2.5/h of N3 sleep was 73% specific and 67% sensitive. An N3 arousal with trunk raising, sitting, speaking, showing an expression of fear/surprise, shouting, or exhibiting sexual behavior was 100% specific for a diagnosis of sexsomnia.
In patients with sexsomnia, videopolysomnography based markers of arousal disorders are intermediate between healthy individuals and patients with other arousal disorders, supporting the concept of sexsomnia as a specialized, but less neurophysiologically severe, NREM parasomnia. Previously validated criteria for arousal disorders partially fit in patients with sexsomnia.
确定最近觉醒障碍的 EEG 和行为标准是否适用于性梦癖。
在视频多导睡眠图中，对 24 例性梦癖患者、41 例觉醒障碍患者和 40 例健康对照者的 N3 睡眠中断时的 EEG 和行为标志物进行回顾性比较。在性梦癖与对照组中，测量了先前提出的支持觉醒障碍诊断的 EEG 和行为切点的特异性和敏感性。
性梦癖和觉醒障碍患者的 N3 片段指数、慢/混合 N3 觉醒指数和 N3 中断期间睁眼次数均高于健康对照组。10 例（41.7%）性梦癖患者（vs. 1 例梦游者和无对照者）在 N3 觉醒期间表现出明显的性行为（自慰、性发声、骨盆推挤和手放在睡衣内）。N3 睡眠片段指数≥6.8/h 的 N3 睡眠和与睁眼相关的两个或更多 N3 觉醒的发生率为 95%特异性，但对诊断性梦癖的敏感性较差（46%和 42%）。N3 睡眠中慢/混合 N3 觉醒指数≥2.5/h 的特异性为 73%，敏感性为 67%。躯干抬高、坐起、说话、表现出恐惧/惊讶的表情、大喊大叫或表现出性行为的 N3 觉醒对性梦癖的诊断具有 100%的特异性。
在性梦癖患者中，基于视频多导睡眠图的觉醒障碍标志物在健康个体和其他觉醒障碍患者之间处于中间状态，支持性梦癖是一种特殊但神经生理学严重程度较低的非快速眼动睡眠障碍的概念。先前验证的觉醒障碍标准部分适用于性梦癖患者。
