Lee Wing Lam Jenny, Wong Oi Yau June, Shetty Marisha, Plunkett Georgina, Walter Lisa M, Davey Margot J, Nixon Gillian M, Horne Rosemary Sc
Department of Paediatrics, Monash University, Melbourne, Australia.
Department of Paediatrics, Monash University, Melbourne, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia.
Sleep Med. 2024 Dec;124:754-762. doi: 10.1016/j.sleep.2024.11.004. Epub 2024 Nov 8.
Currently, diagnosing narcolepsy and idiopathic hypersomnia (IH) in subjectively sleepy children requires an overnight polysomnographic sleep study followed by a daytime multiple sleep latency test (MSLT). We aimed to compare sleep macro-architecture to identify differences between these groups.
All children referred for a MSLT between May 2010 to December 2023 whose parent consented for their data be used in research were eligible. Each child was age- and sex-matched to a control. Sleep stability was defined as the maintenance of a particular sleep stage before waking or transitioning to another sleep state. As a measure of sleep disturbance, the number and duration of bouts of each sleep stage was recorded.
28 children with Narcolepsy, 11 with IH and 26 with subjective sleepiness were included. Children with narcolepsy exhibited higher numbers of transitions to wake after sleep onset compared to their controls and to the subjectively sleepy group (p < 0.001 for both). The number of REM bouts was greater in the narcolepsy group compared to their control group (p < 0.001), the IH group (p < 0.05) and the subjectively sleepy group (p < 0.05), while the average duration of REM bouts was shorter in the narcolepsy group compared to both the IH group (p < 0.05) and subjectively sleepy group (p < 0.05). Mean sleep latency on the MSLT was correlated with a number of polysomnographic variables.
Our study suggests that specific sleep architecture patterns could potentially serve as diagnostic biomarkers for distinguishing paediatric narcolepsy from those with IH and those with a non-diagnostic MSLT.
目前，诊断主观嗜睡儿童的发作性睡病和特发性嗜睡症（IH）需要进行夜间多导睡眠图睡眠研究，随后进行白天多次睡眠潜伏期试验（MSLT）。我们旨在比较睡眠宏观结构，以确定这些组之间的差异。
2010年5月至2023年12月期间所有因MSLT前来就诊且其父母同意将其数据用于研究的儿童均符合条件。每个儿童在年龄和性别上与一个对照组相匹配。睡眠稳定性定义为在醒来或转换到另一种睡眠状态之前维持特定睡眠阶段。作为睡眠干扰的一项指标，记录每个睡眠阶段的发作次数和持续时间。
纳入了28名发作性睡病儿童、11名IH儿童和26名主观嗜睡儿童。与对照组和主观嗜睡组相比，发作性睡病儿童入睡后醒来的转换次数更多（两者均p < 0.001）。与对照组（p < 0.001）、IH组（p < 0.05）和主观嗜睡组（p < 0.05）相比，发作性睡病组的快速眼动（REM）发作次数更多，而与IH组（p < 0.05）和主观嗜睡组（p < 0.05）相比，发作性睡病组的REM发作平均持续时间更短。MSLT上的平均睡眠潜伏期与多个多导睡眠图变量相关。
我们的研究表明，特定的睡眠结构模式可能潜在地作为诊断生物标志物，用于区分小儿发作性睡病与IH患者以及MSLT无诊断意义的患者。
