Recent advance in sleep-related eating disorders / 中华神经医学杂志

Sleep-related eating disorder (SRED) is a sleep disorder characterized by repeated involuntary eating and drinking. The clinic of this disease is not rare, but few reports are noted in China; doctors and patients lack of knowledge. This paper reviews the literature on SRED, summarizes the shortcomings of existing research, and proposes future research directions, aiming to provide references for researchers to further explore this field.

Polysomnographic characteristics of different clinical phenotypes of sleep related rhythmic movement （SRRM） / 中风与神经疾病杂志

@#Objective　To analyze characteristics of video polysomnography （V-PSG） for different clinical phenotypes of sleep related rhythmic movement （SRRM）. Methods　The clinical data of patients with sleep related rhythmic movement diagnosed by video polysomnography（V-PSG） monitoring in our sleep center from December 2017 to August 2020 were analyzed retrospectively，their genders，ages，first episode time，clinical types and PSG results were statistically analyzed. Results　A total of 21 SSRM patients were performed in 959 sleep monitoring cases，including 16 males （76.2%） and 5 females （23.8%）. The mean age was 27.29±11.64 years old，and 17 cases were ≥18 years old. SSRM first occurred in 9 adults （42.9%），4 children （19%），4 patients （19.0%） with unclear onset age，and 4 patients （19.0%） with adolescent onset. The movement frequency of 21 cases （100%） was lower than 0.5 times per second. The clinical manifestations were head shaking type in 10 cases （47.6%），body shaking type in 1 case （4.8%） and mixed type in 10 cases （47.6%）. 14 cases occurred REM in SSRM cases （66.7%），NREM2 2 cases （9.5%%），NREM2+REM3 cases （14.3%），and awake 2 cases （9.5%）. PSG showed that the sleep efficiency of SSRM patients was decreased，the latency period of REM was prolonged and the total waking time after sleep was prolonged，and the total sleep time and sleep stage ratio were approximately normal. Hamilton anxiety score was greater than 8 in 12 cases （57.14%）. Conclusion　Adult SSRM is not uncommon，and it is mostly the first episode in adult life. In adults，SSRM is mainly manifested as head shaking type and mixed type，and the occurrence frequency of REM is the highest. The clinical significance of SSRM and its relationship with REM sleep need to be further studied and evaluated.

The correlations between the clinical and subclinical REM sleep behavior disorder and cognitive function in patients with Parkinson′s disease / 实用医学杂志

Objective To investigate the relationships between the clinical and subclinical REM sleep behavior disorder(sRBD)and the cognitive function in patients with PD. Methods We enrolled 53 patients with PD from the Second Affiliated Hospital of Nanchang University. The age ,gender and education level of each patient were recorded. Patients with dementia were excluded. The correlative scales were assessed by the form of face to face,including Montreal cognitive function score(MoCA),Unified Parkinson Disease Rating Scale(UPDRS), Parkinson Disease Sleep Scale (PDSS) and so on. The sleep quality was assessed by polysomnography(PSG), meanwhile PD patients were divided into the RBD group(PD-RBD),the subclinical RBD group(PD-sRBD)and the normal REM group(PD-REM)based on the polysomnography. The cognitive function was compared among the three groups. Results (1)MoCA score of PD patients in the RBD group was lower than that in the normal REM group(P = 0.032.(2)No significant difference was observed in the cognitive function between the sRBD group and the normal REM group.(3)Length of morbidity of PD patients with RBD was longer than that of PD patients with sRBD(P=0.021). Conclusions The presence of RBD may be an important relative factor for the develop-ment of cognitive dysfunction in PD patients. We haven′t detected that the subclinical RBD was associated with the cognitive dysfunction in patients with PD. It is not clear whether the subclinical RBD in PD patients develops to RBD in all patients,which needs further investigation.

The correlations between the clinical and subclinical REM sleep behavior disorder and cognitive function in patients with Parkinson′s disease / 实用医学杂志

Objective To investigate the relationships between the clinical and subclinical REM sleep behavior disorder(sRBD)and the cognitive function in patients with PD. Methods We enrolled 53 patients with PD from the Second Affiliated Hospital of Nanchang University. The age ,gender and education level of each patient were recorded. Patients with dementia were excluded. The correlative scales were assessed by the form of face to face,including Montreal cognitive function score(MoCA),Unified Parkinson Disease Rating Scale(UPDRS), Parkinson Disease Sleep Scale (PDSS) and so on. The sleep quality was assessed by polysomnography(PSG), meanwhile PD patients were divided into the RBD group(PD-RBD),the subclinical RBD group(PD-sRBD)and the normal REM group(PD-REM)based on the polysomnography. The cognitive function was compared among the three groups. Results (1)MoCA score of PD patients in the RBD group was lower than that in the normal REM group(P = 0.032.(2)No significant difference was observed in the cognitive function between the sRBD group and the normal REM group.(3)Length of morbidity of PD patients with RBD was longer than that of PD patients with sRBD(P=0.021). Conclusions The presence of RBD may be an important relative factor for the develop-ment of cognitive dysfunction in PD patients. We haven′t detected that the subclinical RBD was associated with the cognitive dysfunction in patients with PD. It is not clear whether the subclinical RBD in PD patients develops to RBD in all patients,which needs further investigation.

Two-dimensional Speckle Tracking in Evaluating Obstructive Sleep Apnea Syndrome Left Ventricular Global and Layered Myocardial Strain / 中国医学影像学杂志

Purpose To evaluate left ventricular systolic function of patients with obstructive sleep apnea syndrome (OSAS).Materials and Methods Sixty OSAS patients were divided into 16 cases in mild OSAS group,18 cases in medium OSAS group and 26 cases in severe OSAS group in line with polysomnography results.20 healthy people were in the control group.Two-dimensional speckle tracking imaging was adopted to measure left ventricular global longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS),Endo-LS,Mid-LS and Epi-LS of left ventricular long axial section and EndoCS,Mid-CS and Epi-CS of short axial section in OSAS group and control group.Results ① There was no obvious change of GLS and GCS in mild OSAS group and compared with those in control group (P＞0.05),GRS was increased (P＜0.05).GLS,GRS and GCS in medium OSAS group was decreased when compared with those in control group,and the difference was of statistical significance (P＜0.05).GLS in severe OSAS group was reduced compared with that in control group,mild and medium OSAS group and GRS and GCS were also reduced compared with that in control group and mild OSAS group.The difference was of statistical significance (P＜0.05).② OSAS group was represented by Endo-LS reduction and as OSAS worsened,Endo-LS reduced section was enhanced.③ Starting from medium OSAS group,myocardial circumference strain began to decrease,which was represented by Endo-CS and Mid-CS reduction.Conclusion Adoption of two-dimensional speckle tracking imaging for left ventricular global and layered myocardial strain could figure out early stage left ventricular systolic function disorder in OSAS patients,providing more valuable information for clinical activities and guidance of early intervention for OSAS patients.

Impact of obstructive sleep apnea-hypopnea syndrome on cerebral microbleeds in patients with cerebral infarction / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) on cerebral microbleeds (CMBs) in patients with cerebral infarction.</p><p><b>METHODS</b>Consecutive patients with acute cerebral infarction who had cerebral microbleeds shown by susceptibility-weighted imaging (SWI) were enrolled to undergo polysomnography (PSG). The patients were divided into two groups, namely non-OSAHS group with apnea-hypopnea index (AHI) less than 5 and OSAHS group with greater AHI, and the clinical and radiological features of cerebral microbleeds were compared between them.</p><p><b>RESULTS</b>Forty-nine patients were enrolled in this study, including 27 (55.1%) with both cerebral infarction and OSAHS and 22 (44.9%) with cerebral infarction but not OSAHS. A comparison of the risk factors showed that hypertension, a smoking history, and a history of stroke were more prevalent in patients with OSAHS than in those without OSAHS (P<0.05). The incidences of subclinical stroke in OSAHS and non-OSAHS patients were 37.0% (10/27) and 9.0% (2/22) (P<0.05), respectively. Neurological imaging revealed a greater number of cerebral microbleeds in OSAHS group than in non-OSAHS group (P<0.05). In OSAHS patients, 77.8% of the microbleeds were distributed in cortical-subcortical areas, 55.6% in the basal ganglia area, and 25.9% in the infratentorial area, as compared to the percentages of 50.0%, 40.9% and 50.0% in non-OSAHS patients, respectively (P<0.05). In OSAHS patients, 40.7% also had leukoaraiosis, and 48.1% had two or more causes, as compared to the percentages of 13.6% and 18.2% in non-OSAHS patients, respectively (P<0.05).</p><p><b>CONCLUSIONS</b>OSAHS can be a risk factor for cerebral microbleeds. Patients with both cerebral infarction and OSAHS tend to have greater and more extensive lesions of cerebral microbleeds, more complicated cause of the disease, and a grater likeliness of stroke recurrence.</p>

Morphologic changes in the upper airway in patients with acute cerebral infarction / 中华神经科杂志

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.