Edinger J D, Fins A I, Sullivan R J, Marsh G R, Dailey D S, Hope T V, Young M, Shaw E, Carlson D, Vasilas D
Veterans Affairs Medical Center, Durham, North Carolina 27705, USA.
Sleep. 1997 Dec;20(12):1119-26. doi: 10.1093/sleep/20.12.1119.
Many laboratory polysomnographic (LPSG) studies have shown only modest sleep differences between insomniacs and matched, noncomplaining normal controls. However, the extent to which LPSG methodology affects the outcome of such comparisons has yet to be tested. In the current investigation, 32 (16 females, 16 males) older (age > or = 60 years) insomniacs and an age-matched and gender-matched sample of 32 noncomplaining normal sleepers underwent three consecutive nights of LPSG monitoring and another three consecutive nights of PSG monitoring in their homes (HPSG). By random assignment, one-half of the subjects in each group underwent LPSG first, whereas the remaining subjects underwent HPSG first. Each PSG recording was blindly scored using conventional scoring criteria, and resulting measures of total sleep period, total sleep time, sleep efficiency percent, stage 1 time, slow-wave sleep time, and rapid eye movement latency were used to compare the two subject groups within each PSG recording site (i.e. lab and home). Statistical analyses showed the normals sleepers and insomniacs evidenced similar pronounced first night effects (FNEs) when undergoing LPSG. However, neither mean values of the selected sleep parameters nor measures reflecting their night-to-night variability differentiated the insomniacs from the normal sleepers when such measures were derived from LPSG. In contrast, FNEs were generally absent for both subject groups when they underwent HPSG. Moreover, the insomniacs displayed significantly greater variability in several of their sleep measures during HPSG than did the normal sleepers. Overall, results suggest FNEs are a concern mainly when using LPSG, and HPSG may be more sensitive than LPSG for documenting sleep differences between normal sleepers and insomniacs. Additional studies are needed to determine if the findings reported herein are similar for young and middle-aged adults.
许多实验室多导睡眠图(LPSG)研究表明,失眠症患者与匹配的、无睡眠问题的正常对照组之间的睡眠差异并不显著。然而,LPSG方法对这类比较结果的影响程度尚未得到验证。在本次调查中,32名年龄较大(年龄≥60岁)的失眠症患者(16名女性,16名男性)以及32名与之年龄和性别匹配的无睡眠问题的正常睡眠者,连续三个晚上接受LPSG监测,并在他们家中连续三个晚上接受家庭多导睡眠图(HPSG)监测。通过随机分配,每组一半的受试者先接受LPSG监测,其余受试者先接受HPSG监测。每个多导睡眠图记录均采用传统评分标准进行盲法评分,并使用总睡眠时间、总睡眠时长、睡眠效率百分比、第一阶段睡眠时间、慢波睡眠时间和快速眼动潜伏期等测量指标,在每个多导睡眠图记录地点(即实验室和家中)对两组受试者进行比较。统计分析表明,正常睡眠者和失眠症患者在接受LPSG监测时,都表现出类似的明显首夜效应(FNE)。然而,当这些测量指标来自LPSG时,所选睡眠参数的平均值或反映其夜间变异性的测量指标,均无法区分失眠症患者和正常睡眠者。相比之下,当两组受试者接受HPSG监测时,通常不存在FNE。此外,失眠症患者在HPSG监测期间的几项睡眠测量指标上,表现出比正常睡眠者更大的变异性。总体而言,结果表明FNE主要在使用LPSG时才是一个需要关注的问题,而HPSG在记录正常睡眠者和失眠症患者之间的睡眠差异方面,可能比LPSG更敏感。需要进一步的研究来确定本文报告的结果在年轻和中年成年人中是否相似。