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肌萎缩侧索硬化症中的睡眠障碍及其预后影响——一项回顾性研究

Sleep Disturbances in Amyotrophic Lateral Sclerosis and Prognostic Impact-A Retrospective Study.

作者信息

Silva Filipa, Silva Joelma, Salgueira Sofia, Mendes Ana, Matos Elsa, Conde Bebiana

机构信息

Pulmonology Department, Unidade Saúde Local de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.

Instituto de Investigação e Inovação em Saúde (I3S), 4200-135 Porto, Portugal.

出版信息

Life (Basel). 2024 Oct 11;14(10):1284. doi: 10.3390/life14101284.

Abstract

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease associated with sleep disturbance, namely insomnia and sleep-disordered breathing. This study aims to evaluate the overall sleep characteristics of ALS patients, their association with lung function tests, and possible predictive survival factors. We conducted a retrospective observation study among ALS patients monitored during a pulmonology consultation. Type one polysomnography (PSG) and lung function tests were performed once the patients presented with sleep-related symptoms, and the relationship between their parameters was assessed, as well as a survival analysis. We included 35 patients, with an overall diminished sleep efficiency, a partially conserved forced vital capacity (FVC), and low maximal inspiratory pressure (MIP). A positive correlation between FVC and REM sleep percentage was observed. A survival analysis showed that a normal rapid eye movement (REM) sleep percentage and respiratory disturbance index (RDI) ≥ 15/h were independent predictors of survival. We observed a trend for higher sleep quality in patients with conserved lung function. A better sleep quality was associated with a higher survival. Obstructive events (reduced or absence of airflow associated with continued or increased inspiratory effort) did not seem to impact survival.

摘要

肌萎缩侧索硬化症(ALS)是一种与睡眠障碍相关的神经退行性疾病,即失眠和睡眠呼吸紊乱。本研究旨在评估ALS患者的整体睡眠特征、其与肺功能测试的关联以及可能的生存预测因素。我们对在肺科会诊期间接受监测的ALS患者进行了一项回顾性观察研究。一旦患者出现与睡眠相关的症状,就进行一级多导睡眠图(PSG)和肺功能测试,并评估其参数之间的关系,同时进行生存分析。我们纳入了35例患者,他们的整体睡眠效率降低,用力肺活量(FVC)部分保留,最大吸气压力(MIP)较低。观察到FVC与快速眼动(REM)睡眠百分比之间呈正相关。生存分析表明,正常的快速眼动(REM)睡眠百分比和呼吸紊乱指数(RDI)≥15次/小时是生存的独立预测因素。我们观察到肺功能保留的患者睡眠质量有提高的趋势。更好的睡眠质量与更高的生存率相关。阻塞性事件(与持续或增加的吸气努力相关的气流减少或缺失)似乎对生存没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e138/11508895/01fc6eb6b889/life-14-01284-g001.jpg

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