多导睡眠监测记录什么
多导睡眠监测是完整的整夜睡眠监测,通常在睡眠实验室进行。一张传感器之网同时记录多路信号,使呼吸能够在睡眠本身的背景下被解读。
- 脑电、眼动和颏部传感器判定睡眠分期——浅睡、深睡和快速眼动期——并捕捉每一次短暂的呼吸性觉醒。
- 鼻和口处的气流传感器检测呼吸暂停和低通气。
- 胸带和腹带显示呼吸努力——这正是区分阻塞性与中枢性事件的关键线索。
- 指尖上的[[pulse-oximetry|脉搏血氧仪]]追踪每一次下降中的血氧饱和度。
由于脑电图知道你真正入睡的时刻,实验室就能依据真实睡眠时间计算AHI,并把呼吸暂停与安静的清醒区分开。较简单的家用检测记录呼吸和血氧,但不记录脑电波;它们方便,往往足以确诊明确的阻塞性睡眠呼吸暂停,却可能漏掉较轻或混合型的病例。
睡眠破碎的白天代价
每一次觉醒都会把你从深睡中拽出片刻。把几百次这样的觉醒拼接起来,整整八小时的卧床只换来短得多的一夜休息。结果就是过度白天嗜睡:开会时打盹、开车时拼命撑着不睡、思维迟钝、情绪低落。它是睡眠呼吸暂停最常见的白天症状——也是真正关乎安全的那一个。
为了给嗜睡一个量化值,门诊常用Epworth 嗜睡量表:八种日常情境,每种按打瞌睡的可能性评0到3分。总分从0到24,分数越高,表示在本该清醒时入睡的倾向越强。
Epworth Sleepiness Scale — sample scoring
Chance of dozing (0 = never, 1 = slight, 2 = moderate, 3 = high)
Sitting and reading ............................ 2
Watching TV .................................... 3
Sitting inactive in a public place ............. 2
As a passenger in a car for an hour ............ 3
Lying down to rest in the afternoon ............ 3
Sitting and talking to someone ................. 1
Sitting quietly after lunch (no alcohol) ....... 2
In a car, stopped a few minutes in traffic ..... 1
----
Total .......................................... 17
Rough interpretation:
0 to 10 ..... normal range
11 to 24 ..... above-normal daytime sleepiness <-- score 17
Note: the Epworth measures perceived sleepiness, not
severity of apnea. It guides discussion; it does not
diagnose on its own.