530例发作性睡病患者在未服用精神活性药物时进行清醒维持试验（MWT）的睡眠潜伏期。

Sleep latency on the maintenance of wakefulness test (MWT) for 530 patients with narcolepsy while free of psychoactive drugs.

作者信息

Mitler M M, Walsleben J, Sangal R B, Hirshkowitz M

机构信息

Scripps Research Institute, La Jolla, CA 92037, USA.

出版信息

Electroencephalogr Clin Neurophysiol. 1998 Jul;107(1):33-8. doi: 10.1016/s0013-4694(98)00044-3.

DOI:10.1016/s0013-4694(98)00044-3

PMID:9743270

Abstract

OBJECTIVES

To compare maintenance of wakefulness test (MWT) data gathered at baseline in the course of two, multicenter studies on the therapeutic efficacy of modafinil with published MWT norms.

METHODS

The MWT is a procedure that uses electrophysiological measures to determine the ability to remain awake while sitting in a quiet, darkened room. The test consists of 4 20 min trials conducted 4 times at 2 h intervals commencing 2 h after awakening from a night of sleep. MWT data were gathered at baseline in the course of two, multicenter studies on the therapeutic efficacy of modafinil. Subjects were 17-68 year old men (n = 239) and women (n = 291) diagnosed with narcolepsy according to the International Classification of Sleep Disorders (ICSD). All patients were free of psychoactive medication for a minimum of 14 days.

RESULTS

Mean MWT sleep latency was 6.0 +/- 4.8 min. However, the mean for the first MWT trial was 7.0 min which was longer that the means for the following 3 trials (5.8, 5.6 and 5.7 min, respectively). The 4 distributions of the individual MWT trials were similar and adequately summarized by the distribution of the average MWT sleep latency. As a group, patients with narcolepsy were less able to remain awake than normals; only 8 of 530 (1.5%) patients were able to remain awake on 4 20 min MWT trials compared with 35 of 64 (54.7%) normals in another study. However, using a mean MWT sleep latency of 12 min (the 5th percentile for normals) as the lowest cut-point for normalcy, 15% of patients with narcolepsy appeared to have an unimpaired ability to remain awake.

CONCLUSIONS

The diagnosis of narcolepsy did not always predict inability to remain awake on the MWT. Age, gender and the duration of illness did not predict ability to remain awake. Patients with severe cataplexy and other ancillary symptoms were least able to remain awake on MWT trials. Patients who used tobacco and caffeine moderately had the lowest MWT sleep latencies relative to patients with heavy and light use.

摘要

目的

比较在两项关于莫达非尼治疗效果的多中心研究过程中，于基线期收集的维持觉醒测试（MWT）数据与已发表的MWT标准。

方法

MWT是一种利用电生理测量来确定在安静、昏暗房间中坐着时保持清醒能力的程序。该测试包括4次20分钟的试验，从夜间睡眠醒来2小时后开始，每隔2小时进行一次，共进行4次。在两项关于莫达非尼治疗效果的多中心研究过程中，于基线期收集MWT数据。受试者为17 - 68岁的男性（n = 239）和女性（n = 291），根据国际睡眠障碍分类（ICSD）被诊断为发作性睡病。所有患者至少14天未使用精神活性药物。

结果

MWT睡眠潜伏期的平均值为6.0 +/- 4.8分钟。然而，第一次MWT试验的平均值为7.0分钟，长于随后3次试验的平均值（分别为5.8、5.6和5.7分钟）。各个MWT试验的4种分布相似，且通过平均MWT睡眠潜伏期的分布能充分概括。作为一个群体，发作性睡病患者比正常人更难以保持清醒；在另一项研究中，530名患者中只有8名（1.5%）能够在4次2分0钟的MWT试验中保持清醒，而64名正常人中有35名（54.7%）能够做到。然而，将平均MWT睡眠潜伏期12分钟（正常人的第5百分位数）作为正常的最低切点，15%的发作性睡病患者似乎保持清醒的能力未受损。