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青少年睡眠-清醒时相延迟障碍与发作性睡病在心理社会因素及睡眠研究结果上的差异。

Differences in psychosocial factors and sleep study findings between delayed sleep-wake phase disorder and hypersomnia in teenagers.

作者信息

Kamiyama Yayumi, Kaneko Yoshiyuki, Saitoh Kaori, Furihata Ryuji, Konno Michiko, Uchiyama Makoto, Suzuki Masahiro

机构信息

Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan.

Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.

出版信息

Sleep Biol Rhythms. 2023 Jan 10;21(2):241-247. doi: 10.1007/s41105-022-00441-1. eCollection 2023 Apr.

Abstract

Central hypersomnia (HS) and delayed sleep-wake phase disorder (DSWPD) appear commonly in adolescents, and they severely reduce quality of life and have an enormous impact on academic performance and other aspects of development. Although these disorders are thought to be considerably different in etiology, it is sometimes difficult to distinguish them because of their similar clinical features. This study aimed to compare psychosocial factors and sleep study findings between HS and DSWPD in teenagers. The clinical data of 89 teenagers who visited the psychiatric section of the Sleep Medicine Center of Nihon University Itabashi Hospital from January 2013 to December 2019 were analyzed. Psychosocial factors were evaluated at the first visit, and polysomnography (PSG) and the multiple sleep latency test (MSLT) were performed for patients deemed to require definitive diagnosis. Compared with patients with HS, those with DSWPD had a higher rate of mother's employment, introversion, adjustment problems, events that triggered the disorder, concurrent mental disorders, habitual lateness, and difficulty attending school or work. PSG did not show any differences in sleep parameters between the two disorders, except for sleep latency. On the MSLT, sleep latency was shorter in those with HS on the second, third, and fourth tests. The present results suggest that focusing on psychosocial factors could be useful for differential diagnosis of the two disorders that appear commonly in adolescents.

摘要

中枢性睡眠过度(HS)和睡眠-觉醒时相延迟障碍(DSWPD)在青少年中很常见,它们严重降低生活质量,对学业成绩和其他发育方面产生巨大影响。尽管这些障碍在病因上被认为有很大差异,但由于它们临床特征相似,有时很难区分。本研究旨在比较青少年HS和DSWPD之间的心理社会因素和睡眠研究结果。分析了2013年1月至2019年12月期间就诊于日本大学板桥医院睡眠医学中心精神科的89名青少年的临床资料。在首次就诊时评估心理社会因素,对被认为需要明确诊断的患者进行多导睡眠图(PSG)和多次睡眠潜伏期试验(MSLT)。与HS患者相比,DSWPD患者的母亲就业比例、内向性格、适应问题、引发该障碍的事件、并发精神障碍、习惯性迟到以及上学或工作困难的发生率更高。除睡眠潜伏期外,PSG未显示两种障碍在睡眠参数上有任何差异。在MSLT中,HS患者在第二次、第三次和第四次测试时的睡眠潜伏期较短。目前的结果表明,关注心理社会因素可能有助于对青少年中常见的这两种障碍进行鉴别诊断。

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本文引用的文献

1
Sleep Disorders in Adolescents.青少年睡眠障碍。
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Delayed sleep-wake phase disorder.睡眠时相延迟障碍
J Thorac Dis. 2018 Jan;10(Suppl 1):S103-S111. doi: 10.21037/jtd.2018.01.11.
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Idiopathic Hypersomnia.特发性嗜睡症
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Sleep Med Rev. 2016 Oct;29:23-33. doi: 10.1016/j.smrv.2015.08.007. Epub 2015 Sep 3.
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The Humanistic and Economic Burden of Narcolepsy.发作性睡病的人文和经济负担
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