Aichi Medical University, Department of Neuropsychiatry, Epilepsy Center, Japan.
Aichi Medical University, Department of Neuropsychiatry, Epilepsy Center, Japan.
Seizure. 2019 Jul;69:279-282. doi: 10.1016/j.seizure.2019.04.006. Epub 2019 May 18.
The present study examined clinical variables related to excessive daytime sleepiness (EDS) and sleep disorders in patients with epilepsy (PWE), with special focus on antiepileptic drugs (AEDs), to determine whether sleep-related problems in PWE are correlated with their involvement in traffic accidents.
325 PWE completed the Epworth Sleepiness Scale (ESS) and 322 the Pittsburgh Sleep Quality Index (PSQI). 239 PWE with a valid driver's license were requested to answer questions related to traffic accidents.
The presence of focal seizures with impaired awareness, age, and administration of lacosamide were each shown to have a significant impact on ESS score. Furthermore, administrations of valproate and lacosamide, as well as sleep-promoting agents other than AEDs (SPA) had a significant impact on the presence of sleep disorder diagnosed with the PQSI. In view of traffic accidents in total, age and LEV had an impact on traffic accident occurrence. In view of an accident in association with an epileptic seizure, SPA was the only variable with a significant impact. As for a traffic accident not related to epileptic seizure, no factors were found to have a significant impact on that dependent variable. No correlation was found between ESS score and any of those 3 traffic accident groupings, which was also true for PSQI.
Neither daytime sleepiness nor sleep disorder was found to be correlated with traffic accidents by PWE who drove. Furthermore, no AED was shown to be correlated with daytime sleepiness or increased risk of a traffic accident.
本研究旨在探讨与癫痫患者(PWE)日间嗜睡(EDS)和睡眠障碍相关的临床变量,特别关注抗癫痫药物(AEDs),以确定 PWE 的睡眠相关问题是否与其卷入交通事故有关。
325 名 PWE 完成了 Epworth 嗜睡量表(ESS)和 322 名 Pittsburgh 睡眠质量指数(PSQI)。要求 239 名有有效驾照的 PWE 回答与交通事故相关的问题。
局灶性有认知障碍的癫痫发作、年龄和拉考酰胺的使用均显著影响 ESS 评分。此外,丙戊酸和拉考酰胺的使用以及除 AED 以外的促进睡眠的药物(SPA)对根据 PSQI 诊断的睡眠障碍的存在有显著影响。就总体交通事故而言,年龄和 LEV 对交通事故的发生有影响。就与癫痫发作相关的事故而言,SPA 是唯一有显著影响的变量。对于与癫痫发作无关的交通事故,没有发现任何因素对该因变量有显著影响。ESS 评分与这 3 个交通事故分组中的任何一个都没有相关性,PSQI 也是如此。
驾驶的 PWE 既没有发现日间嗜睡也没有发现睡眠障碍与交通事故相关。此外,没有 AED 与日间嗜睡或交通事故风险增加相关。