Division of Neurology Hospital São Lucas PUCRS, Porto Alegre RS, Brazil.
Sleep Med. 2012 May;13(5):536-41. doi: 10.1016/j.sleep.2011.12.015. Epub 2012 Mar 18.
The aims of this study were to evaluate the sleep habits of children with drug resistant epilepsy and to correlate sleep abnormalities with epilepsy and level of intelligence.
Twenty five subjects with drug resistant epilepsy (14 males, age range 2-16.4 years) were recruited for this study. A control group was formed by 23 normal children. Two instruments to assess sleep habits were administered to the patients with epilepsy: a questionnaire on sleep habits (to preschool children) and a questionnaire on sleep behavior (for children aged more than seven years old); a cognitive test (Wechsler Intelligence Scale for Children-WISC) was also performed. Patients underwent a complete polysomnographic study and sleep parameters, including CAP, were analyzed and correlated according to cognitive-behavioral measures in children with epilepsy.
Children with drug-resistant epilepsy and severe mental retardation showed sleep abnormalities such as low sleep efficiency, high percentage of wakefulness after sleep onset, reduced slow wave sleep, and reduced REM sleep. Sleep microstructure evaluated by means of CAP analysis showed a decrease in A1 index during N3 in patients with more severe cognitive impairment. Children with epilepsy and cognitive impairment (n=10) had higher Sleep Behavior Questionnaire for Children (SBQC) total scores (65.60 ± 18.56) compared to children with epilepsy and normal IQ (50.00 ± 10.40), p<0.05.
Children with drug-resistant epilepsy have a greater incidence of sleep problems regarding qualitative aspects, macrostructure, and CAP. The decrease of CAP rate and of A1, mainly during slow wave sleep (associated to REM sleep reduction), might represent a sleep microstructural pattern of intellectual disability.
本研究旨在评估耐药性癫痫患儿的睡眠习惯，并将睡眠异常与癫痫和智力水平相关联。
本研究纳入了 25 名耐药性癫痫患儿（男 14 例，年龄 2-16.4 岁）。另设立 23 名正常儿童作为对照组。我们使用两种评估睡眠习惯的工具对癫痫患儿进行评估：睡眠习惯问卷（适用于学龄前儿童）和睡眠行为问卷（适用于 7 岁以上儿童）；同时还进行了认知测试（韦氏儿童智力量表-WISC）。所有患儿均接受了完整的多导睡眠图检查，并根据癫痫患儿的认知行为测量结果分析和关联睡眠参数，包括 CAP。
耐药性癫痫伴严重智力障碍的患儿存在睡眠异常，如睡眠效率低、睡眠潜伏期后觉醒率高、慢波睡眠减少和 REM 睡眠减少。通过 CAP 分析评估的睡眠微结构显示，认知障碍较重的患儿在 N3 期的 A1 指数降低。认知障碍（n=10）的癫痫患儿的儿童睡眠行为问卷（SBQC）总评分（65.60±18.56）高于无认知障碍且智力正常的癫痫患儿（50.00±10.40），p<0.05。
耐药性癫痫患儿在定性方面、宏观结构和 CAP 方面存在更多的睡眠问题。CAP 率和 A1 的降低，主要发生在慢波睡眠期间（与 REM 睡眠减少相关），可能代表智力障碍的睡眠微结构模式。
