- 期刊
Polysomnographic and Clinical Correlates of Epic Dream Complaints: A Retrospective Study of 28 Taiwanese Adults
臨床上抱怨多夢患者在多項睡眠生理腦波儀上的表現：在睡眠門診中28個台灣成人患者的回溯性研究
摘要
目的：描述一群整晚作夢好像沒有在睡覺，白天起床時卻覺得全身疲倦，無精打采的患者，在多項睡眠生理腦波儀檢查上的表現。病人及方法：這是一個以28個成人患者為研究對象的回溯性研究（17個男性及11個女性；平均年齡39歲，年齡介於25歲至63歲），28個患者是在1年半的時間，陸陸續續因晚上睡覺多夢，白天起床時卻覺得全身疲倦，而來睡眠門診求診。患者經過臨床的睡眠病史問診及理學和神經學的檢查後，皆安排了過夜的多項睡眠生理腦波儀的檢查。夢的內容並沒有被系統性的分析，也沒有精神方面的諮詢或心理測試。結果：根據夢的內容多夢症患者可分為兩組，一組為故事的多夢症患者（共有5位），另外一組為非故事性的多夢症患者（共有23位）。而在多項睡眠生理腦波儀的檢查結果中，有22個患者並沒有什麼明顯的異常，但卻有6個患者在多項睡眠生理腦波儀中出現睡眠間間斷斷的現象（其中有5位有阻塞性睡眠呼吸暫停，另外一位為週期性肢體抽動的患者）。在這28個患者中，其多項睡眠生理腦波儀的檢查結果，睡眠結構大都有一個趨向，那就是睡眠結構變得較淺，第1及第2睡眠期增加，第3及第4睡眠期和快速動眼期減少，這種情形可能是第一晚效應。在接受多項睡眠生理腦波儀的檢查時，所有的患者均報告有多夢的感覺，就如平常一般。結論：我們認為多夢症患者可依作夢內容及多項睡眠生理腦波儀的檢查結果，將多夢症患者分為三組。第一組為作夢內容像連續劇一樣，其多項睡眠生理腦波儀的檢查結果都為正常，此組我們稱為故事性的多夢症，然而此組依據多項睡眠生理腦波儀的檢查結果又可分為兩組，一組為正常，另一組為不正常。目前已有兩組分別住在台灣及北美的多夢症患者被報告（亞洲人及白種人），其中相似處及相異處正被確認中。
並列摘要
Objective: To describe polysomnographic and clinical findings in a group of patients with epic dreaming, viz. relentless dreaming perceived to occur throughout sleep during most nights with subsequent daytime fatigue. Patients and Methods: This is a retrospective study of a consecutive series of 28 adult patients (17 men, 11women; mean age is 39 yrs, range 25-63) who were self-referred with epic dream complaints over a 1.5 year period. The setting was a general hospital sleep clinic in Taiwan. Clinical interviews and physical/neurologic exams were conducted by one physician, followed by hospital-based, overnight polysomnorgraphy(PSG). Dreams were not systematically analyzed (either at home or in the sleep laboratory), psychiatric interviews were not conducted, and psychometric testing was not administered. Results: Two groups of epic dreamers were identified on the basis of dream content: “story” epic dreamers (n=5) and “non-story” epic dreamers (n=23). PSG fidings were unremarkable in 22 patients, whereas sleep fragmentation disorders were found in 6 patients (n=5, obstructive sleep apnea; n=1, periodic limb movement disorder). For both groups, there was a major shift towards light sleep, with increased percentages of stages 1+2, and decreased percentages os stages 3+4 and REM, which may or may not have been a “first night effect”. All patients reported typical epic dreaming during their PSG studies. Conclusions: This study suggests epic dreaming should be divided into three groups. The dream content of the first group was like a “soap opera” but PSG results were normal, we call this as story epic dreaming. The second group’s dream didn’t involve a story with a plot. Reported dreams were random, with disconnected content, and without emotionality, and they never formed a discernible story. We called this non-story epic dreaming. According to PSG results, the non-story epic dreaming group could be subdivided into two groups, one with normal PSG results, and the other with abnormal PSG results. Epic dreaming has now been reprted in two ethnic groups (Asian and Caucasian) residing in Taiwan and North America, with similarities and differences being identified.