Abstract: Background  Panic disorder refers to the repeated or unexpected anxiety or panic attacks. It makes patients feel extreme pain. Although the episodes of most patients with panic disorder happen at daytime, the nocturnal panic attacks (NPA) are quite common. Paients pay more attention to NPA. Insomnia is more serious in patients with NPA than those patients with panic disorder attack at daytime. Many patients may occur anxiety and avoidance behavior after NPA. Patients are often afraid of sleeping, or even do not sleep. The aim of this study is to analyze polysomnographic (PSG) parameter changes and clinical concomitant symptoms of patietns with NPA, to explore the characteristics of sleep, in order to provide better diagnosis, differential diagnosis and treatment for these patients. Methods  The features of sleep of 20 NPA patients and 23 healthy controls were monitored by video-PSG. Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were used to assess the state of anxiety, depression, and dyssomnia of the patients. Results  In comparison with normal control group, the NPA group showed shortened total sleep time (TST), decreased sleep efficiency (SE) and sleep maintenance rate, delayed arousal time, increased number of arousal and number of arousal episode longer than 5 minutes, increased percentage of non-rapid eye movement (NREM) sleep stage Ⅰ, decreased percentage of NREM sleep stageⅢ and percentage of rapid eye movement (REM) sleep (P < 0.05, for all). There was no significant difference in sleep latency (SL) and REM sleep latency (RSL), wake-up time, the number of REM sleep, percentage of NREM sleep stage Ⅱ, apnea index (AI) and apnea hypopnea index (AHI) between two groups (P > 0.05, for all). In NPA group, there were 13 cases (13/20) with anxiety, 17 (17/20) with depression, 13 cases/times (13/20) with difficulty of falling asleep, 17 cases/times (17/20) with difficulties in maintaining sleep (frequent arousals and difficult to fall asleep again) and 7 cases/times (7/20) with wake up early. Conclusion  NPA patients present decreased deep sleep, increased shallow sleep and poor sleep quality, and are mostly accompanied with mild or moderate depression and (or) anxiety, and dyssomnia. Application of polysomnography can rule out those diseases (for example, obstructive sleep apnea syndrome, nightmare, etc) which may easily confuse with NPA, and avoid misdiagnosis.

Key words: Night terrors, Polysomnography, Anxiety, Depression, Sleep disorders

摘要： 研究背景 惊恐发作系指反复发生、有时为不可预料的焦虑或惊恐症状。尽管大多数惊恐发作都在白天发作，但夜间惊恐发作也相当常见，而更关注夜间发作。夜间惊恐发作患者较白天发作患者存在更严重的失眠，大多数患者可因一次夜间惊恐发作而继发预期焦虑和回避行为。本研究通过对夜间惊恐发作患者视频多导睡眠图监测参数和临床伴随症状的分析，探讨其睡眠特征，为更好诊断、鉴别诊断和治疗夜间惊恐发作提供依据。方法 采用夜间视频多导睡眠图监测20 例夜间惊恐发作患者和23 例健康志愿者睡眠过程，汉密尔顿焦虑量表（HAMA）和抑郁量表（HAMD，20 项）评价患者焦虑、抑郁症状及睡眠障碍。结果 与正常对照组相比，夜间惊恐发作组患者总睡眠时间减少、睡眠效率和睡眠维持率降低、觉醒时间延长、觉醒次数和> 5 min 的觉醒次数增加，以及非快速眼动睡眠期Ⅰ期所占比例增加、慢波睡眠和快速眼动睡眠期所占比例减少（均P < 0.05）；而两组患者睡眠潜伏期、快速眼动睡眠潜伏期、醒起时间、快速眼动睡眠次数、非快速眼动睡眠期Ⅱ期所占比例、呼吸暂停指数和睡眠呼吸暂停低通气指数比较，差异无统计学意义（均P > 0.05）。13 例（13/20）夜间惊恐发作患者伴焦虑症状、17 例（17/20）伴抑郁症状；13 例次（13/20）伴入睡困难、17 例次（17/20）伴睡眠维持障碍（频繁觉醒和再度入睡困难）、7 例次（7/20）伴早醒。结论 夜间惊恐发作患者深睡眠减少、浅睡眠增加、睡眠质量差，且多伴有轻或中度焦虑和（或）抑郁症状及睡眠障碍。夜间多导睡眠图监测可用于排除易与夜间惊恐发作相混淆
的疾病（如睡眠呼吸暂停综合征、梦魇）等，避免误诊。

关键词: 夜惊, 多道睡眠描记术, 焦虑, 抑郁, 睡眠障碍