Narcolepsia e início súbito de períodos REM após despertares noturnos

Sleep-onset REM periods during the night as a marker for narcolepsy

Narcolepsia e início súbito de períodos REM após despertares noturnos

Sleep-onset REM periods during the night as a marker for narcolepsy

Ronald Cowan^I; Rubens Reimão^II; Helio Lemmi^III; Roger Vander Zwagg^IV

^IBolsista em Neurosciências. Department of Neurodiagnostics, Baptist Memorial Hospital, Memphis, Tennessee, E.U.A

^IINeurologista. Department of Neurodiagnostics, Baptist Memorial Hospital, Memphis, Tennessee, E.U.A

^IIIClinicai Professor, Department of Neurology, University of Tennessee Center for Health Sciences

^IVEstatísticista. Bolsa CAPES 3502/82

RESUMO

O objetivo deste estudo foi verificar as relações entre aspectos polissono-gráficos e em especial a passagem súbita da vigília para o sono REM a partir de despertares espontâneos noturnos e a síndrome narcoléptica. Comparamos os dados de 55 narcolépticos com os de 93 não-narcolépticos com sonolência excessiva diurna. A distribuição etária e de sexo foi semelhante nas duas amostras. Os seguintes parâmetros não revelaram diferença significante entre os dois grupos: tempo total na cama, tempo total de sono como percentagem do tempo na cama, tempo nos estágios 3, 4 e REM, número de despertares breves, número de movimentos corpóreos e densidade REM. Número de episódios de início súbito de períodos REM após despertares espontâneos, tempo no estágio 1 e número de despertares completos e prolongados foram maiores nos narcolépticos. Tempo total de sono, latência de sono, latência do estágio REM e tempo no estágio 2 foram mais curtos nos narcolépticos. Em conclusão, a arquitetura do sono mostrou diferenças nítidas entre os dois grupos analisados. O início abrupto de períodos REM após despertares noturnos espontâneos foi típico dos narcolépticos e, com as demais características do registro, pode auxiliar na diferenciação destes dois grupos nosológicos.

SUMMARY

The objective of this study was to evaluate polysomnographic data, and especially the sudden onset of REM periods that occur after spontaneous awakenings during the night as characteristics of narcolepsy. We evaluated 148 consecutive patients with excessive daytime somnolence, except for those with sleep apnea. After clinical evaluation, all-night polysomnographic recording and multiple sleep latency test, 55 were diagnosed as narcoleptics and 93 were grouped as non-narcoleptics. The mean age of narcoleptics was 42.9 ± 14.4 years old and the non-narcoleptics were 40.3 ± 13.5 years old. Polysomnographic variables were compared between both samples using unpaired t test. Non-significant differences were found for: sex; total time in bed; total sleep time; time in stages 3, 4 and REM; number of arousals (<30 sec); number of body movements; REM density. The following significant differences were found: number of sleep onset REM periods during the night was higher for narcoleptics (p<0.001); total sleep time was lower for narcoleptics (p=0.02); sleep latency was shorter for narcoleptics (p<0.001); REM latency to stage 1 was shorter for narcoleptics (p<0.001); time in stage 1 was higher for narcoleptics (p<0.001); time in stage 2 was lower for narcoleptics (p<0.001); number of full awakenings (>30 sec) was higher for narcoleptics (p<0.001); number of awakenings longer than 5 minutes was higher for narcoleptics (p=0.002). In conclusion, there were marked differences in the sleep architecture between the two groups. The occurence of sleep-onset REM periods after spontaneous night awakenings was typical of narcolepsy and may be used as an adjunct, with other polysomnographic findings, in differentiating these two conditions.

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Trabalho do Department of Neurodiagnostics, Baptist Memorial Hospital, Memphis, Tennessee, E.U.A.

Sleep Disorders Center, Department of Neurodiagnostics, Baptist Memorial Hospital -899 Madison Avenue - Memphis, Tennessee, 38146 - U.S.A.

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Datas de Publicação

• Publicação nesta coleção
  13 Ago 2012
• Data do Fascículo
  Set 1985