专题笔谈
夜间呻吟:一种新的睡眠呼吸障碍
许力月
张希龙
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DOI: 10.3760/cma.j.issn.1001-0939.2015.09.007
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摘要

夜间呻吟(catathrenia),也被称做睡眠相关的呻吟(nocturnal groaning),1983年由De Roek等 [ 1 ] 首先发现并公开发表。典型的夜间呻吟表现为深吸气后呼气相延长并伴随呻吟般单调的声音,多发生在年轻人,主要就诊原因为社交障碍,在2005年国际睡眠疾病分类第2版(international classification of sleep disorder, ICSD–2)中将其归类为异态睡眠(parasomnia) [ 2 ] 。由于夜间呻吟具有典型的呼吸模式改变,但究竟属于何种睡眠障碍一直存在争议。2006年报道夜间呻吟合并阻塞性睡眠呼吸暂停的患者使用持续正压通气(continuous positive airway pressure, CPAP)治疗后夜间呻吟好转 [ 3 ] ,2014年国际睡眠疾病分类标准第3版(ICSD–3)将夜间呻吟正式纳入睡眠呼吸障碍中,与单纯鼾声合并列为正常变异或单纯症状 [ 4 ] 。对于这一新的睡眠呼吸障碍,目前病例报道不到100例,国内外均认识不足,由于其以夜间发声为主要表现,在门诊中常被误认为是阻塞性睡眠呼吸暂停,又因夜间呻吟患者多导睡眠监测(polysomnograph, PSG)表现与中枢性睡眠呼吸暂停PSG表现相似,均有口鼻气流暂停伴胸腹运动消失,临床常被误诊为中枢性睡眠呼吸暂停。

引用本文

许力月,张希龙. 夜间呻吟:一种新的睡眠呼吸障碍[J]. 中华结核和呼吸杂志,2015,38(9):656-658.

DOI:10.3760/cma.j.issn.1001-0939.2015.09.007

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夜间呻吟(catathrenia),也被称做睡眠相关的呻吟(nocturnal groaning),1983年由De Roek等 [ 1 ]首先发现并公开发表。典型的夜间呻吟表现为深吸气后呼气相延长并伴随呻吟般单调的声音,多发生在年轻人,主要就诊原因为社交障碍,在2005年国际睡眠疾病分类第2版(international classification of sleep disorder, ICSD–2)中将其归类为异态睡眠(parasomnia) [ 2 ]。由于夜间呻吟具有典型的呼吸模式改变,但究竟属于何种睡眠障碍一直存在争议。2006年报道夜间呻吟合并阻塞性睡眠呼吸暂停的患者使用持续正压通气(continuous positive airway pressure, CPAP)治疗后夜间呻吟好转 [ 3 ],2014年国际睡眠疾病分类标准第3版(ICSD–3)将夜间呻吟正式纳入睡眠呼吸障碍中,与单纯鼾声合并列为正常变异或单纯症状 [ 4 ]。对于这一新的睡眠呼吸障碍,目前病例报道不到100例,国内外均认识不足,由于其以夜间发声为主要表现,在门诊中常被误认为是阻塞性睡眠呼吸暂停,又因夜间呻吟患者多导睡眠监测(polysomnograph, PSG)表现与中枢性睡眠呼吸暂停PSG表现相似,均有口鼻气流暂停伴胸腹运动消失,临床常被误诊为中枢性睡眠呼吸暂停。
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张希龙,Email: mocdef.3ab612591gnolixgnahz
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