【摘要】 目的　探讨失眠症患者第一晚效应 (firstnighteffect ,FNE)的多导睡眠图表现及其相关因素。方法　对 2 5例非器质性失眠症患者进行了连续两夜的多导睡眠图记录和一系列量表的评定。结果　第一晚的多导睡眠图显示 ,失眠症患者的睡眠总时间减少 ,睡眠潜伏期延长 ,REM睡眠的潜伏期延长、时间缩短、百分比减少 ;完全正常 (或逆转 )的FNE较少 ,正常FNE较逆转FNE更常见。患者的主观评价与上述改变基本一致 ,发生FNE的患者有一定特点 :年龄小、自评失眠程度重 ,睡眠图改变不显 ,正常FNE较多 ;相反年龄大、失眠以早醒为主、白天的情绪及困倦受影响大、对睡眠的关注多、易受外界干扰 ,且睡眠图指标改变显著 ,逆转FNE较多。FNE与EPQ、SAS、SDS等无显著相关。睡眠纺锤密度和K综合波密度与正常FNE显著相关。结论　失眠症患者存在第一晚效应 ,表现形式个体差异大 ,与失眠亚型、严重程度及个体素质等有关 ,提示不同患者对环境的适应能力不同 ;睡眠纺锤和K综合波可能成为评价个体对新环境适应能力的很有价值的指标。第一晚PSG资料不应轻易丢弃。更多还原

【Abstract】 Objective To study the first night effect(FNE)on polysomnogram(PSG) and correlative factors in insomnia.Method Two consecutive nights of PSG were recorded,and a battery of questionnaires were used on 25 non-organic insomnia(ICD-10).Results Several changes of PSG were significant in the first night,including total sleep time decreased,sleep latency and REM latency prolonged,REM sleep time and percent decreased.Some insomniacs had completely normal or reverse FNE,others had only part FNE.The probability of normal FNE was higher than that of reverse FNE.Results of subjective evaluations were similarly.There was significant correlative relationship between FNE and some factors,that is,normal FNE often occurred in younger patients with more serious insomnia by self-evaluated and mild change of PSG,while reverse FNE often occurred in older patients with rising too early,relatively serious dysthymia and daytime sleepiness caused by insomnia,more attention on sleep disorders,easily disturbed by outside factors,and more obvious changes of PSG.There was no significant correlation between FNE and scales of EPQ,SAS,SDS and others.The density of sleep spindle and K-complex were significantly correlated with normal FNE.Conclusion The results suggest that FNE does exist in non-organic insomniacs,closely correlates with the state of disease and varies individually,which indicated differently adaptive ability.The density of sleep spindle and K-complex might be very useful in evaluating the ability.Information of the first night might be very important.更多还原