Maganti Rama, Hausman Nancy, Koehn Monica, Sandok Evan, Glurich Ingrid, Mukesh Bickol N
Department of Neurology, Barrows Neurological Institute, Phoenix, AZ, USA.
Epilepsy Behav. 2006 Feb;8(1):272-7. doi: 10.1016/j.yebeh.2005.11.002. Epub 2005 Dec 13.
Excessive daytime sleepiness (EDS) and sleep complaints are common among adults with epilepsy. We hypothesized that children with epilepsy have worse daytime sleepiness compared with controls.
Children with and without epilepsy between ages 8 and 18 were recruited for the study. Parents and children were asked to fill out the Pediatric Sleep Questionnaire (PSQ) and Pediatric Daytime Sleepiness Scale (PDSS), respectively. The Mann-Whitney U test was used for group comparisons, with the Fischer exact or chi2 test for categorical variables. Regression analysis was used to identify predictors of EDS.
Twenty-six patients and matched controls were recruited for the study. Parents of children with epilepsy more often reported EDS (P < 0.001), symptoms of sleep-disordered breathing (P < 0.001), and parasomnias (P < 0.001) compared with controls. On the PDSS, children with epilepsy reported worse daytime sleepiness scores compared with controls (15.48 +/- 6.4 vs 11.88 +/- 5.25, P = 0.037). Based on conditional logistic regression modeling, symptoms of excessive daytime sleepiness [corrected] (OR = 15.3, 95% CI = 1.4-166.6) and parasomnias (OR = 12.4, 95% CI = 1.01-151.6) were significantly associated with having epilepsy when adjusted for duration of nightime sleep. Further, 10 children (38.5%) with epilepsy reported positive sleep-disordered breathing, whereas no one in the control group reported SDB (P < 0.001) [corrected] Epilepsy syndrome, anticonvulsants used, and presence or absence of seizure freedom, however, were not significant predictors of EDS among patients.
Daytime sleepiness appears to be common in children with epilepsy, and may be due to underlying sleep disorders. Further confirmatory studies are needed using screening questionnaires and formal sleep studies to systematically study the prevalence of sleep complaints and role of sleep disorders in these patients.
白天过度嗜睡（EDS）和睡眠问题在成年癫痫患者中很常见。我们推测癫痫患儿与对照组相比白天嗜睡情况更严重。
招募8至18岁患癫痫和未患癫痫的儿童参与研究。分别要求家长和儿童填写儿童睡眠问卷（PSQ）和儿童白天嗜睡量表（PDSS）。采用曼-惠特尼U检验进行组间比较，分类变量采用费舍尔精确检验或卡方检验。采用回归分析确定EDS的预测因素。
招募了26例患者及匹配的对照组参与研究。与对照组相比，癫痫患儿的家长更常报告患儿存在EDS（P < 0.001）、睡眠呼吸紊乱症状（P < 0.001）和异态睡眠（P < 0.001）。在PDSS量表上，癫痫患儿报告的白天嗜睡得分比对照组更差（15.48 ± 6.4 vs 11.88 ± 5.25，P = 0.037）。基于条件逻辑回归模型，校正后的白天过度嗜睡症状（OR = 15.3，95% CI = 1.4 - 166.6）和异态睡眠（OR = 12.4，95% CI = 1.01 - 151.6）在调整夜间睡眠时间后与患癫痫显著相关。此外，10例（38.5%）癫痫患儿报告存在阳性睡眠呼吸紊乱，而对照组中无人报告睡眠呼吸紊乱（校正后P < 0.001）。然而，癫痫综合征、使用的抗惊厥药物以及是否无癫痫发作，在患者中并非EDS的显著预测因素。
白天嗜睡在癫痫患儿中似乎很常见，可能是由于潜在的睡眠障碍所致。需要使用筛查问卷和正式的睡眠研究进行进一步的验证性研究，以系统地研究这些患者的睡眠问题患病率及睡眠障碍的作用。
