Sleep structure of rapid eye movement sleep disorder patients and its correlations with emotional state, autonomic nerve symptom and sleep quality / 中华神经医学杂志

ABSTRACT

Objective To evaluate the sleep structure of rapid eye movement sleep disorder (RBD) patients and its correlations with emotional state,autonomic nerve system function symptoms,and sleep quality.Methods Twenty-two RBD patients examined in our hospital from October 2014 to May 2016 who complained of behavior disorders and conformed diagnosis by video-polysomnography (v-PSG) were chosen as RBD group;23 healthy gender,age and education-level matched subjects confirmed without RBD by v-PSG were selected as control group.Their emotional state,autonomic nerve function and sleep quality were assessed by center for epidemiological survey depression scale (CES-D),apathy evaluation scale (AES),scale for outcomes in PD for autonomic symptoms (SCOPA-AUT),and scale for outcomes in PD for sleep (SCOPA-SLEEP).The differences in sleep structures,periodic leg movement index (PLMI),apnea hypopnea index (AHI) and arousal index between RBD group and control group were compared.The differences of scores of emotional state,autonomic nerve system function symptoms were compared between the two groups.The correlations of sleep structure with emotional state,autonomic nerve system function symptom,and sleep quality in RBD group were analyzed.Results As compared with those of the control group,the proportion of non-rapid eye movement (NREM)-Ⅰ sleep of RBD group was significantly increased,proportions of NREM-Ⅱ sleep and NREM-Ⅲ sleep were statistically reduced,PLMI,CES-D scores,urinary and digestive system questionnaire and overall scores in the RBD group were significantly increased (P＜0.05).In patients from RBD group,CES-D scores were positively correlated with proportion of NREM-I sleep (r=0.520,P=0.000);nighttime sleepiness questionnaire and overall scores were positively correlated with PLMI (r=0.465,P=0.029;r=0.444,P=0.039);daytime sleepiness scores were negatively correlated with proportion of NREM-Ⅲ sleep (r=-0.480,P=0.041);cardiovascular system symptom was correlated with PLMI (r=0.439,P=0.041).Conclusion RBD patients suffer sleep structure disturbance,depression tendency,digestive and urinary system of autonomic nerve symptoms;sleep quality scores and total scores,cardiovascular system symptoms scores are positively correlated with LMI;daytime sleepiness is negatively correlated with reducing phase Ⅲ sleep,CES-D scores are correlated with increasing NREM-I sleep and unbalanced neurotransmitter,especially,5-TH level.