Merica H, Blois R, Gaillard J M
HUG Hôpitaux Universitaires de Genève, Division de Neuropsychiatrie, Geneva, Switzerland.
Eur J Neurosci. 1998 May;10(5):1826-34. doi: 10.1046/j.1460-9568.1998.00189.x.
To determine whether the spectral characteristics of the sleep electroencephalogram (EEG) of insomniacs differ from that of healthy subjects, we compared in each of the first four non-rapid eye movement (NREM) and rapid eye movement (REM) episodes: (a) the time courses of absolute power, averaged over the subjects in each group, for the delta, theta, alpha, sigma and beta frequency bands; (b) the relationship between these time courses; and (c) the overnight trend of integrated power in each frequency band. The results show that NREM power, for all frequencies below the beta range, has slower rise rates and reaches lower levels in the insomniac group, whereas beta power is significantly increased. In REM, insomniacs show lower levels in the delta and theta bands, whereas power in the faster frequency bands is significantly increased. Thus, the pathophysiology of insomnia is characterized not only by the generally acknowledged slow wave deficiency, but also by an excessive hyperarousal of the central nervous system throughout the night, affecting both REM and NREM sleep. This hyperarousal is interpreted in terms of the neuronal group theory of sleep which provides a possible explanation for the discrepancies observed between subjective impressions and objective measures of sleep. Also, it is suggested that the progressive hyperpolarization of the thalamocortical neurons as sleep deepens is slower in the patient population and that this may explain the observed slow wave deficiency. The homeostatic control of slow wave activity, on the other hand, would appear to be intact in the patient population.
为了确定失眠症患者的睡眠脑电图（EEG）频谱特征是否与健康受试者不同，我们在最初的四个非快速眼动（NREM）和快速眼动（REM）阶段分别进行了比较：（a）每组受试者的δ、θ、α、σ和β频段绝对功率的时间进程；（b）这些时间进程之间的关系；以及（c）每个频段积分功率的夜间趋势。结果表明，在β频段以下的所有频率中，NREM功率在失眠症患者组中上升速度较慢且达到的水平较低，而β功率则显著增加。在REM阶段，失眠症患者在δ和θ频段的功率水平较低，而在较快频率频段的功率则显著增加。因此，失眠症的病理生理学不仅表现为普遍公认的慢波缺乏，还表现为整个夜间中枢神经系统过度觉醒，影响REM和NREM睡眠。这种过度觉醒根据睡眠的神经元群理论进行解释，该理论为睡眠主观印象和客观测量之间观察到的差异提供了一种可能的解释。此外，有人提出，随着睡眠加深，丘脑皮质神经元的逐渐超极化在患者群体中较慢，这可能解释了观察到的慢波缺乏。另一方面，慢波活动的稳态控制在患者群体中似乎是完整的。
