The Study Of Sleep Progress And Architecture Changes In Amyotrophic Lateral Sclerosis And Correlation Factors

Objective: To investigate nocturnal sleep progress and sleep architecturechanges, correlation factors in patients with amyotrophic lateral sclerosis (ALS).Methods: By polysomnography (PSG), we detected nocturnal sleep progressand sleep architecture between40ALS patients (study group) and40healthysubjects (control group), compared the difference of related indicators between thetwo groups, analyzed related factors of sleep progress and sleep architecture on ALSpatients.Results:(1) Study group compared with the control group, total sleep time(TST)was significantly shorter (P＜0.001), sleep efficiency(SE) was significantly lower (P＜0.001), wake after sleep onset(WASO) was significantly longer (P＜0.001);Apperception time(AT) and sleep latency(SL) tended to be longer, but the differencewas not significant(P＞0.05).(2) Study group compared with the control group,stage2sleep, stage3sleep and rapid eye movement sleep was significantly shorter(P＜0.001, P＜0.001, P＜0.05); Stage1sleep was not significantly longer (P＞0.05).(3) The study group of sleep progress correlation factors analysis showed that:the patients’ age was negatively correlated with TST(r＝-0.312，P＝0.05), thepatients’minimum SpO2was positively correlated with TST(r＝0.328，P＜0.05), thepatients’body mass index（BMI）, the course ofALS, hospital anxiety scale(HADSa),hospital depression scale(HADSd), the amyotrophic lateral sclerosis functionalrating scale revised(ALSFRS-R), apnea-hypopnea index(AHI) and average SpO2hadno linear regression relationship with TST(P＞0.05); The correlation factorsmentioned above had no linear regression relationship with SL, SE and AT(P＞0.05);The patients’ age was positively correlated with WASO(r＝0.335，P＜0.05), theother factors had no linear regression relationship with WASO(P＞0.05).(4) Thestudy group of sleep architecture correlation factors analysis showed that: the courseof ALS was negatively correlated with S2sleep(r＝-0.337，P＜0.05), ALSFRS-R and minimum SpO2were positively correlated with S2sleep(r＝0.319，P＜0.05andr＝0.338，P＜0.05), the patients’ age, BMI, HADSa, HADSd, AHI and averageSpO2had no linear regression relationship with S2sleep(P＞0.05); The patients’ agewas negatively correlated with REM（r＝-0.549，P＜0.05）, the other factors had nolinear regression relationship with REM (P＞0.05); The correlation factorsmentioned above had no linear regression relationship with S1sleep and S3sleep(P＞0.05).Conclusion: The ALS patients show significant changes in sleep progress andsleep architecture, the patients’ age, the course of ALS, the degree of illness andminimum SpO2may be the primary correlation factors. PSG should be used in theroutine evaluation ofALS patients.