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睡眠时异常动作和行为的概述

Author
Bradley V Vaughn, MD
Section Editor
Alon Y Avidan, MD, MPH
Deputy Editor
April F Eichler, MD, MPH
Translators
陈兴泳, 副主任医师

引言

睡眠时异常动作和行为是一大群夜间事件的组成部分，可能发生在睡眠、觉醒，或睡眠与觉醒互相转换时期。这些事件最常见于生命早期，约15%-20%的儿童和4%的成年人受累[1-4]。

夜间事件通常分为简单行为(如，单一的动作、重复或周期性动作、节律性动作)和复杂行为(如，梦呓、睡行症、夜惊、梦境表演)(表 1)。大多数简单动作发生在觉醒-睡眠或睡眠-觉醒转换期间，或发生在浅睡非快动眼睡眠相(non-rapid eye movement, NREM)期间(图 1)。复杂行为可源于觉醒、NREM和快速眼睡眠相(rapid eye movement, REM)3个正常状态的控制机制被破坏。

偶尔，睡眠时简单或复杂的运动模式是癫痫发作、精神分裂事件，甚至诸如低血糖等生理状态的表现。因此，临床医生应意识到夜间事件可能是特定神经疾病、内科疾病、精神病、或睡眠障碍的一种表现。另一方面，儿童时期的一些夜间行为可能是正常的，特别是觉醒障碍和噩梦。

详细的病史是确定基础病因线索的基础，病史包括患者及他人的详细描述(最好是床伴或见证的家人).临床医生面临的挑战是需识别出某些夜间事件何时标志着某种可治疗的基础疾病，何时表示一种新出现的神经系统异常，以及何时是一种年龄相符的良性发作。

本专题介绍一种评估和诊断睡眠期间异常动作和行为的方法。其他关于发生于儿童和成人的特异性异态睡眠和睡眠相关运动障碍的诊断和治疗参见其他专题。 (参见“儿童睡行症及其他深眠状态”和“成人非快动眼睡眠觉醒障碍”和“快动眼睡眠相睡眠行为障碍”和“不安腿综合征”和“儿童不安腿综合征/Willis-Ekbom病和周期性肢体运动障碍”)

                   

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Literature review current through: 2017-07 . | This topic last updated: 2015-10-06.
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