Honda Makoto, Kimura Shinya, Sasaki Kaori, Wada Masataka, Ito Wakako
Sleep Disorders Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya, Tokyo 156-8506 Japan.
Koishikawa Tokyo Hospital, Institute of Neuropsychiatry, 4-45-16 Otsuka, Bunkyo, Tokyo 112-0012 Japan.
Sleep Biol Rhythms. 2021 Sep 25;20(1):107-114. doi: 10.1007/s41105-021-00346-5. eCollection 2022 Jan.
Multiple sleep-onset rapid eye movement periods (SOREMPs) are involved in the pathophysiology of narcolepsy, but it is not clear whether the lack of multiple SOREMPs is associated with the pathophysiology of idiopathic hypersomnia or not. We examined the significance of multiple SOREMPs in patients with pathological sleep prolongation.
Participants were consecutive patients complaining of unexplained sleepiness and agreed to a 3-day-sleep studies; 24 h polysomnography (PSG) followed by standard PSG and multiple sleep latency test (MSLT). Forty-one (26 females, 21.9 ± 8.1 years old, BMI 20.4 ± 2.3 kg/m) of 54 eligible patients without other sleep pathologies showed pathological sleep prolongation. We subdivided them into those with and without multiple SOREMPs on MSLT and compared clinical and PSG variables between groups.
Six of 41 (14.6%) patients showed multiple SOREMPs on MSLT. There were almost no differences in sleep variables between those with and without multiple SOREMPs. We only found shorter mean sleep latency on MSLT and more REM cycles on 24 h PSG in those with multiple SOREMPs (adjusted = 0.016 and 0.031). The frequencies of REM-related phenomena and clinical symptoms related to idiopathic hypersomnia were not different between groups.
Our results indicated that patients with pathological sleep prolongation had the same clinical profiles regardless of the status of SOREMPs, suggesting the absence of multiple SOREMPs, prerequisite for the diagnosis of idiopathic hypersomnia, is not a specific feature of pathological sleep prolongation. Confirmation of sleep prolongation alone could be a diagnostic tool for idiopathic hypersomnia.
多次睡眠起始快速眼动期（SOREMPs）参与发作性睡病的病理生理过程，但尚不清楚缺乏多次SOREMPs是否与特发性嗜睡症的病理生理相关。我们研究了多次SOREMPs在病理性睡眠延长患者中的意义。
参与者为连续的主诉不明原因嗜睡且同意进行为期3天睡眠研究的患者；先进行24小时多导睡眠图（PSG）检查，随后进行标准PSG和多次睡眠潜伏期试验（MSLT）。54例符合条件且无其他睡眠疾病的患者中，41例（26例女性，年龄21.9±8.1岁，体重指数20.4±2.3kg/m）表现出病理性睡眠延长。我们将他们根据MSLT上有无多次SOREMPs进行分组，并比较两组之间的临床和PSG变量。
41例患者中有6例（14.6%）在MSLT上表现出多次SOREMPs。有多次SOREMPs和无多次SOREMPs的患者在睡眠变量方面几乎没有差异。我们仅发现有多次SOREMPs的患者在MSLT上平均睡眠潜伏期较短，在24小时PSG上快速眼动周期更多（校正后P值分别为0.016和0.031）。两组之间与快速眼动相关现象的频率以及与特发性嗜睡症相关的临床症状并无差异。
我们的结果表明，病理性睡眠延长的患者，无论SOREMPs状态如何，临床特征相同，这表明缺乏多次SOREMPs（特发性嗜睡症诊断的前提条件）并非病理性睡眠延长的特异性特征。仅确认睡眠延长可能是特发性嗜睡症的一种诊断工具。
