Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.
Department of Clinical Neurophysiology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Dev Med Child Neurol. 2019 Feb;61(2):181-185. doi: 10.1111/dmcn.13973. Epub 2018 Jul 20.
To compare the efficacy of the main methodologies in attaining sleep and electroencephalography (EEG) abnormalities in children with a view to producing recommendations on best practice.
Fifty-one UK centres participated. Methods for sleep induction (sleep deprivation, melatonin, and combined sleep deprivation/melatonin) were compared. Data pertaining to demographics, achievement of stage II sleep, and recording characteristics (duration of study, presence of epileptiform activity in awake/sleep states) were prospectively collected for consecutive patients in November and December 2013.
Five hundred and sixty-five patients were included. Age range was 1 years to 17 years (mean 7y 10mo), 27.7 per cent had an underlying neurobehavioural condition. Stage II sleep was achieved in 69 per cent of sleep deprived studies, 77 per cent of melatonin studies, and 90 per cent of combined intervention studies (p<0.001, χ ). In children who slept, there was no difference between the three interventions in eliciting epileptiform discharges. In children who did not sleep, epileptiform abnormalities were seen more often than after sleep deprivation alone (p=0.02, χ ). Seizures were rare.
Combined sleep deprivation/melatonin is more effective than either method alone in achieving sleep. The occurrence of epileptiform activity during sleep is broadly similar across the three groups. We recommend the combined intervention to induce sleep for paediatric EEG.
Combined sleep deprivation/melatonin is more effective in achieving sleep than either sleep deprivation or melatonin alone. Sleep latency is shorter with combined sleep deprivation/melatonin. When children do sleep, there is no difference in the occurrence of epileptiform abnormalities between different induction methods. Seizures are rare in sleep electroencephalography recordings.
比较主要方法在儿童睡眠和脑电图（EEG）异常方面的疗效，以期提出最佳实践建议。
51 家英国中心参与。比较了睡眠诱导方法（睡眠剥夺、褪黑素和联合睡眠剥夺/褪黑素）。2013 年 11 月和 12 月，前瞻性收集了连续患者的人口统计学数据、实现 II 期睡眠的数据以及记录特征（研究持续时间、清醒/睡眠状态下癫痫样活动的存在）。
共纳入 565 例患者。年龄范围为 1 岁至 17 岁（平均 7 岁 10 个月），27.7%有神经行为基础疾病。在睡眠剥夺研究中，69%、褪黑素研究中 77%和联合干预研究中 90%实现了 II 期睡眠（p<0.001，χ²）。在入睡的儿童中，三种干预措施在诱发癫痫样放电方面没有差异。在未入睡的儿童中，与单独睡眠剥夺相比，更常出现癫痫样异常（p=0.02，χ²）。癫痫发作很少见。
联合睡眠剥夺/褪黑素比单独使用任何一种方法更有效地诱导睡眠。三组睡眠时癫痫样活动的发生率大致相似。我们建议采用联合干预措施诱导儿科 EEG 睡眠。
联合睡眠剥夺/褪黑素在诱导睡眠方面比单独使用睡眠剥夺或褪黑素更有效。联合睡眠剥夺/褪黑素的睡眠潜伏期更短。当儿童入睡时，不同诱导方法之间癫痫样异常的发生率没有差异。在睡眠脑电图记录中癫痫发作很少见。
