Maia Susana, Soares Joana Isabel, Borges Daniel Filipe, Casalta-Lopes João, Gonçalves Marta
Sleep Medicine Center, Hospital CUF Porto, Porto, Portugal.
Department of Pediatrics, Unidade Local de Saúde de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Can J Neurol Sci. 2025 May 26:1-9. doi: 10.1017/cjn.2025.10114.
Actigraphy provides an objective measure of sleepiness and is recommended by the American Academy of Sleep Medicine for use 7-14 days prior to multiple sleep latency testing. It plays a valuable role in the differential diagnosis of hypersomnolence.
Our aim was to provide a comprehensive summary of actigraphy features in central disorders of hypersomnolence (CDH).
Data were sourced from six bibliographic databases. Fixed- or random-effects models were applied to compare patients with narcolepsy type 1 (NT1) to controls.
Of the 1,737 publications identified in our search, 8 studies met the inclusion criteria. The total sample consisted of 473 participants, encompassing patients with NT1, idiopathic hypersomnia (IH), hypersomnolence with normal CSF hypocretin-1 levels, Kleine-Levin syndrome (KLS), traumatic brain injury (TBI), major depressive disorder (MDD), myotonic dystrophy (MD), primary insomnia and healthy controls. Actigraphy devices varied across studies. Compared to control subjects, NT1 patients had lower total sleep time (TST), sleep efficiency and daytime motor activity, with increased wake after sleep onset, awakenings, nocturnal motor activity and longest nap duration. In KLS, TST was higher during hypersomnia episodes than during asymptomatic phases. TBI and MDD patients had a higher TST than the control group, while MD patients had a lower TST than patients with IH.
Actigraphy is a valuable tool for objectively assessing sleep and can assist in detecting CDH. However, the absence of standardized guidelines limits their broader implementation in clinical practice.
活动记录仪可客观测量嗜睡程度，美国睡眠医学会推荐在多次睡眠潜伏期测试前7 - 14天使用。它在过度嗜睡的鉴别诊断中发挥着重要作用。
我们的目的是全面总结中枢性过度嗜睡障碍（CDH）的活动记录仪特征。
数据来源于六个文献数据库。应用固定效应或随机效应模型将1型发作性睡病（NT1）患者与对照组进行比较。
在我们检索到的1737篇文献中，有8项研究符合纳入标准。总样本包括473名参与者，涵盖NT1患者、特发性嗜睡症（IH）患者、脑脊液下丘脑分泌素-1水平正常的过度嗜睡患者、克莱恩-莱文综合征（KLS）患者、创伤性脑损伤（TBI）患者、重度抑郁症（MDD）患者、强直性肌营养不良（MD）患者、原发性失眠患者和健康对照组。各研究中使用的活动记录仪各不相同。与对照组相比，NT1患者的总睡眠时间（TST）、睡眠效率和日间运动活动较低，睡眠后觉醒、夜间觉醒次数、夜间运动活动增加，最长午睡时间延长。在KLS患者中，嗜睡发作期间的TST高于无症状期。TBI和MDD患者的TST高于对照组，而MD患者的TST低于IH患者。
活动记录仪是客观评估睡眠的重要工具，有助于检测CDH。然而，缺乏标准化指南限制了其在临床实践中的广泛应用。
