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Objective To investigate influence of mirtazapine on polysomnograpy (PSG) of depression dysphylaxia patient and treatment effect.Methods 22 dysphylaxia patients and 22 healthy contrast persons were detected by PSG.The group of dysphylaxia patients were re-detected PSG 6 weeks later after treatment by Mirtazapine.In order to evaluate the patient' symptoms of depression and early awakening,the scale of HAMD was utilized at the time before and after 2 weeks,6 weeks treatment by mirtazapine.To compare changes of PSG index,HAMD scores and dysphylaxia scores before and after treatment.Results Compared with healthy controls,there existed much deviation with dysphylaxia patients on PSG index.6 weeks after mirtazapine treatment,the PSG showed the sleeping latency had shortened to ( 16.9 ± 6.6) min,sleep efficiency had improved ( 85.4 ± 6.7 ) ％,awake time had shortened (27.7 ± 10.4)min,sleep maintenance rate had risen (87.9 ±5.3)％,decrease (9.7±4.1 )％ of the S1 sleeping stage percentage,S2 had increased ( 148.0 ±30.7)％,REM density had decreased (56.1 ±3.8)％.the difference was significant (P＜0.05).The scores of HAMD and early awakening after treatment were significantly lower than before treatment,the difference was significant (P＜0.01 ).Correlation analysis showed there was no significant correlation between the HAMD,dysphylaxia reduced rate and changes of PSG all indicators(P ＞ 0.05 ).Conclusion It may be one of the biological markers for dysphylaxi in shortened of REM sleep latency,prolonged of REM sleep time and increased of REM activity and density.There is no correlation between post-treatment changes of PSG.
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BACKGROUND AND OBJECTIVES: Tonsillectomy for upper airway obstruction in children has increased but there isn't enough objective data to support such assessment. The purpose of this study was to establish some objective guide for surgery in obstructive apneic children using polysomnography and to compare the polysomnographic results with predictive clinical data, so as to determine the prevalence of obstructive sleep apnea (OSA) with suggestive history. We also tried to understand the characteristics of OSA in children. MATERIALS AND METHODS:Predictive value of OSA was scored based on history, physical examination and X-ray images and compared with the standard overnight polysomnography in fifty-one children who were suggestive of OSA. Postoperative polysomnography was performed in five children who remained apneic. RESULTS: Twenty-two (43%) children with suggestive OSA had respiratory disturbance index (RDI) greater than 5. Among thirty-five (68.6%) who underwent surgery, five (9.8%) children remained apneic with snoring but mean and the longest apnea duration reduced significantly. There was no difference between the obstructive group and non-obstructive group in sleep architecture but minimum oxygen saturation, apnea index, mean apnea duration and hypopnea index showed significant difference. Predictive clinical score and RDI had weak correlation (r=0.25). Non-obstructive group showed higher composition of centeral apnea than the obstructive group. CONCLUSION: History, physical examination and X-ray studies alone are not sufficient to assess the severity of OSA. Polysomnographic study adjusted for children should be done for correct diagnosis in children who do not show any other indication for surgery.