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睡眠儿童:当前多重睡眠延迟测试的诊断标准是否足够?

Aveena Anantharajah¹, Margot J Davey², Gillian M Nixon²

¹Melbourne Children's Sleep Centre, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Melbourne, Australia.

|January 20, 2024

概括

使用多重睡眠延迟测试 (MSLT) 的儿科过度白天嗜睡 (EDS) 诊断可能会错过成人标准的病例. 12分钟的平均睡眠延迟值和更少的午睡可以改善儿科麻醉症和异常性高睡眠症的检测.

科学领域:

神经学神经学
睡眠医学睡眠医学
儿科神经学儿科神经学

背景情况:

过度的白天嗜睡 (EDS) 在儿童中很普遍.
目前通过多重睡眠延迟测试 (MSLT) 诊断EDS的诊断标准是基于成人标准.
12分钟的平均睡眠延迟 (MSL) 门的实用性和儿科MSLTs第五次午睡的影响需要调查.

研究的目的:

描述使用12分钟MSL门建议的儿科MSLT结果.
评估儿科MSLTs第五次小睡的诊断收益率.
评估当前成人MSLT标准对于诊断儿童麻醉症和异常性高睡眠症 (IH) 的适用性.

主要方法:

在2004年至2021年期间进行的214个儿科MSLT的回顾性分析.
适用麻醉症的标准定义 (MSL ≤8min,≥2个睡眠开始的REM周期) 和IH (MSL ≤8min,<2个SOREM).
对模两可的MSLT结果 (MSL 8-12分钟和/或≥2个SOREM) 的分析以及第五次午睡的影响.

主要成果:

麻醉症被诊断为22% (n=48),IH在10% (n=22),和21% (n=44) 有模糊的结果.
在老年儿童和女性中,模两可的MSLT结果更为常见.
第五次小睡很少改变MSLT的结果,通常会增加MSL.

结论:

儿童MSLT的很大一部分使用成人标准产生模两可的结果,这可能导致失误诊断麻醉症和IH.
修改后的MSLT协议具有12分钟的MSL值,可以提高儿童的诊断准确性.
对于大多数儿科病例来说,四次午睡的MSLT协议似乎足够,而第五次午睡只在边界情况下才需要.

关键词:

这是一种超眠症 (hypersomnolence).平均睡眠延迟时间麻醉症是一种精神障碍.快速眼睛运动 (REM) 睡眠是什么?

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