Jain Sejal V, Horn Paul S, Simakajornboon Narong, Glauser Tracy A
Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
J Child Neurol. 2013 Jan;28(1):77-82. doi: 10.1177/0883073812440326. Epub 2012 May 10.
Sleep-related breathing disruptions in children with epilepsy are common and can range from primary snoring to obstructive sleep apnea. Untreated obstructive sleep apnea can lead to significant morbidity. This study aimed to identify factors associated with its occurrence and severity in children with epilepsy. Children with epilepsy and sleep disruption were evaluated with polysomnography and diagnosed with obstructive sleep apnea or primary snoring. Statistical analyses were done to identify differences within both the groups and among the subjects in the obstructive sleep apnea group. Uncontrolled epilepsy was a risk factor for obstructive sleep apnea (80%) compared with primary snoring (47%, P = .02). Obstructive index increased with increasing number of antiepileptic drugs. In children with epilepsy and disturbed sleep, obstructive sleep apnea is associated with uncontrolled epilepsy and is more severe with polytherapy use. Children with uncontrolled seizures on antiepileptic polytherapy should be routinely screened for obstructive sleep apnea.
癫痫患儿中与睡眠相关的呼吸障碍很常见，范围从单纯打鼾到阻塞性睡眠呼吸暂停。未经治疗的阻塞性睡眠呼吸暂停可导致严重发病。本研究旨在确定癫痫患儿中与阻塞性睡眠呼吸暂停的发生及其严重程度相关的因素。对有癫痫和睡眠障碍的患儿进行多导睡眠图评估，并诊断为阻塞性睡眠呼吸暂停或单纯打鼾。进行统计分析以确定两组之间以及阻塞性睡眠呼吸暂停组内受试者之间的差异。与单纯打鼾（47%，P = 0.02）相比，癫痫未得到控制是阻塞性睡眠呼吸暂停的一个危险因素（80%）。阻塞指数随着抗癫痫药物数量的增加而升高。在有癫痫和睡眠障碍的患儿中，阻塞性睡眠呼吸暂停与癫痫未得到控制有关，并且在联合治疗时更严重。接受抗癫痫联合治疗但癫痫发作未得到控制的患儿应常规筛查阻塞性睡眠呼吸暂停。
