"Sleeping in seconds" during the day is also a disease! These sleep disorders are easily misdiagnosed

World Sleep Hygiene Day is celebrated on 21 March, and this year's theme is "Good Sleep, Healthy Together". According to the "2021 White Paper on Exercise and Sleep" released by the China Sleep Research Association, more than 300 million people in China currently have sleep disorders.

Professor Pan Jiyang, director of the Sleep Medicine Center of the First Affiliated Hospital of Jinan University, introduced that the symptoms of narcolepsy and obstructive sleep apnea syndrome are similar to many diseases and are easily misdiagnosed. If there is a situation of "second sleep" during the day and multiple awakenings at night, it is recommended to go to a regular hospital that opens a department related to sleep medicine for medical examination and make a clear diagnosis as soon as possible.

Junior high school students "sleep for seconds" between classes and almost fell injured

Junior high school student Xiaoxue (pseudonym) is the learning committee member of the class. But for nearly half a year, she often fell asleep suddenly in class, lasting several minutes and then suddenly waking up. In the long run, her grades slipped quickly, and she tried to adjust her sleep on her own but did not get better.

One day, when she was talking to her classmates during recess, she suddenly fainted, but fortunately she was supported by her classmates in time. After a while, she woke up again and said confusedly, "How did I just fall?" ”

Xiaoxue's teacher informed her family in time, and her parents immediately took her to a nearby hospital. But she did an electrocardiogram, an EEG, a head magnetic resonance and other tests, but the results did not show any abnormalities.

After ruling out organ lesions, the doctor suggested that she go to the sleep clinic to see. Therefore, Xiaoxue's parents took her to the Sleep Medicine Center of the First Affiliated Hospital of Jinan University for treatment. The medical staff conducted a detailed medical history collection, psychiatric examination, various physical examinations and emotional and sleep-related questionnaires for Xiaoxue, and also improved the monitoring of polysomnography at night and the multiple nap sleep latency test (MSLT), and the test results clearly pointed to a disease - narcolepsy.

"Narcolepsy is characterized by uncontrollable drowsiness, narcolepsy, sleep paralysis, hallucinations to fall asleep, and nighttime sleep disturbances. Sleep lasts from a few minutes to tens of minutes, and can occur several to dozens of times a day. Pan Jiyang said that narcolepsy is a lifelong sleep disorder that can seriously affect the quality of life of patients. In addition, more than half of people with narcolepsy can see limb weakness and drooping or even cataplexy, which can lead to accidents that can be life-threatening.

Why does Xiaoxue get sick? Pan Jiyang introduced that the cause of narcolepsy is not yet clear, and it is generally believed to be the result of the interaction between the environment and genetic factors. According to statistics, the prevalence of narcolepsy in the mainland is about 0.04%. Prevalence is roughly equal in men and women. Studies have shown that narcolepsy, if not diagnosed and treated in time, is often accompanied by anxiety, depression, social phobia and obesity.

Pan Jiyang introduced that at present, there are three main types of treatment for narcolepsy: first, general treatment, such as regular, sufficient night sleep, and planned lunch break during the day; followed by drug treatment, such as mental uplifters (such as methylphenidate hydrochloride, modafinil), anti-cataplexy drugs, γ-oxybutyrate and other drugs; and finally, psychological intervention, doctors will carry out psychological counseling and encouragement for patients.

Nocturnal panic is not necessarily an emotional problem

Mr. Wang is 50 years old and has a history of hypertension for 5 years, but his blood pressure is well controlled and he usually loves exercise. But 3 months ago, he suddenly felt wheezing and palpitations in his sleep, and suddenly woke up with cold limbs, numbness in his fingers, and a strong sense of near-death.

"I woke up feeling particularly panicked, as if the worst was about to happen." Mr. Wang said that although resting for more than half an hour can be roughly relieved, it is more difficult to fall asleep again, and it can be 2-3 times a night. At work the next day, he also felt drowsy, tired and powerless, and lost interest in external things.

After 3 days of symptoms, Mr. Wang went to a number of hospitals for medical treatment, including cardiovascular medicine, endocrinology, neurology, and psychiatry. However, he did not have obvious organ lesions, the use of drugs to treat anxiety was not obvious, and nocturnal panic still recurred.

At the Sleep Clinic of the First Affiliated Hospital of Jinan University, the doctor conducted a detailed diagnostic evaluation of Mr. Wang, combined with the relevant sleep scale examination, considering that Mr. Wang's disease may be obstructive sleep apnea syndrome (OSA).

Mr. Wang conducted nocturnal polysomnography monitoring and sleep-breathing monitoring at the center, and was finally diagnosed with obstructive sleep apnea syndrome with nocturnal panic attacks. After Mr. Wang listened to the doctor's advice to wear a ventilator for treatment, the night panic attack finally disappeared, and the symptoms of daytime sleepiness also improved significantly.

"Obstructive sleep apnea syndrome is a sleep-related respiratory disorder that is common in life but difficult to identify immediately and may delay treatment." Pan Jiyang said that if you encounter a doctor who does not understand a disease such as sleep disorders, the disease can easily be missed or misdiagnosed as another disease. However, after a clear diagnosis, symptoms can be effectively alleviated through timely and systematic drug treatment.

Obstructive sleep apnea syndrome is a sleep-related respiratory disease characterized by sleep snoring with apnea and daytime sleepiness, with a prevalence of 2% to 4%. Studies have shown that patients with untreated severe obstructive sleep apnea syndrome have a 3.8-fold higher case fatality rate than the general population.

Pan Jiyang introduced that the most important treatment method for obstructive sleep apnea syndrome is continuous positive pressure ventilation in the airway, that is, the use of a ventilator to support the airway, so that the upper respiratory tract will not collapse during sleep, which can effectively eliminate nocturnal snoring, improve nocturnal apnea and hypopnea, and correct nocturnal hypoxia. Sleeping well at night also results in significant improvements in symptoms such as daytime drowsiness, headaches, and memory loss.

"High sleep quality is often more important than long sleep duration." Pan Jiyang said that patients with obstructive sleep apnea syndrome should be treated in time, otherwise they will cause insufficient oxygen supply to the brain because of frequent apnea, which will seriously endanger life and health. Therefore, if there are symptoms such as insomnia, fear, and palpitation, you must go to the sleep medicine clinic as soon as possible and intervene as soon as possible to improve your quality of life.

[Reporter] Zhu Xiaofeng

[Correspondent] Zhang Xiaotao Zhang Cancheng

【Author】 Zhu Xiaofeng

Guangdong health headlines