Stein M B, Millar T W, Larsen D K, Kryger M H
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
Am J Psychiatry. 1995 Aug;152(8):1168-73. doi: 10.1176/ajp.152.8.1168.
The authors examined the nocturnal breathing patterns of patients with panic disorder to determine whether these individuals had respiratory irregularities at a time when anxiety was not manifest.
Respiratory polysomnography was conducted on 14 medication-free patients with panic disorder and 14 healthy comparison subjects. Semiautomated indices of ventilatory variability were calculated for representative 3-minute, artifact-free sleep samples, and manually scored indices of irregular breathing were rated (blind to diagnosis) for the entire last 2 nights of sleep.
Patients with panic disorder had evidence of abnormal sleep breathing as indicated by increased irregularity in tidal volume during REM and an increased rate of microapneas (i.e., brief [5-10-second] pauses in breathing). A subgroup of patients (including some with recent sleep panic attacks) had indices of subtle disorders in breathing during sleep that were above the 95th percentile for the comparison subjects.
These findings extend the observations in the awake state that patients with panic disorder breathe more irregularly than healthy comparison subjects. The irregularities may be attributable to altered brainstem sensitivity to CO2 or to other as yet unexplained factors. A possible relationship between irregular nocturnal breathing and sleep panic attacks is discussed.
作者研究了惊恐障碍患者的夜间呼吸模式，以确定这些个体在未表现出焦虑时是否存在呼吸不规则情况。
对14名未服用药物的惊恐障碍患者和14名健康对照者进行了呼吸多导睡眠图检查。针对代表性的3分钟无伪迹睡眠样本计算通气变异性的半自动指标，并对整个最后两晚的睡眠进行不规则呼吸的人工评分（对诊断不知情）。
惊恐障碍患者有睡眠呼吸异常的证据，表现为快速眼动期潮气量不规则增加以及微呼吸暂停发生率增加（即呼吸短暂[5 - 10秒]暂停）。一组患者（包括一些近期有睡眠惊恐发作的患者）在睡眠期间的呼吸细微紊乱指标高于对照者的第95百分位数。
这些发现扩展了在清醒状态下的观察结果，即惊恐障碍患者的呼吸比健康对照者更不规则。这些不规则情况可能归因于脑干对二氧化碳的敏感性改变或其他尚未解释的因素。讨论了夜间呼吸不规则与睡眠惊恐发作之间的可能关系。
