Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Epilepsy Behav. 2020 Mar;104(Pt A):106919. doi: 10.1016/j.yebeh.2020.106919. Epub 2020 Feb 12.
Clinical factors associated with daytime sleepiness and insomnia in persons with epilepsy (PWE) were examined in this cross-sectional study of 126 participants (men, 50.8%). Excessive daytime sleepiness (EDS; score of ≥11 on the Epworth Sleepiness Scale (ESS)) was noted in 17.5% of participants (mean score, 6.1 ± 4.2), and moderate-to-severe insomnia (Insomnia Severity Index (ISI) scores of ≥15) was noted in 20.6% (mean score, 7.8 ± 6.4). Linear regression analyses revealed that ESS scores were independently associated with obstructive sleep apnea (OSA; snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender (STOP-Bang) score of ≥3), an antiepileptic drug (AED) load of >3, depression (Patient Health Questionnaire-9 (PHQ-9) score of ≥10), female sex, and nocturnal seizures. Insomnia Severity Indices were independently associated with depression and anxiety (Generalized Anxiety Disorder-7 (GAD-7) score of ≥7). Notably, significant sex differences were found. Epworth Sleepiness Scale scores were associated with OSA in men but were associated with depression in women. In addition, anxiety was associated with insomnia in women only. Overall, OSA and depression were the most important significant clinical factors associated with daytime sleepiness and insomnia, respectively. However, there were sex differences for the associations between individual factors and sleep disturbances.
本横断面研究纳入了 126 名参与者（男性 50.8%），分析了与癫痫患者（PWE）日间嗜睡和失眠相关的临床因素。17.5%的参与者存在日间嗜睡（ESS 评分≥11）（平均评分 6.1±4.2），20.6%的参与者存在中重度失眠（ISI 评分≥15）（平均评分 7.8±6.4）。线性回归分析显示，ESS 评分与阻塞性睡眠呼吸暂停（OSA；打鼾、疲倦、观察到的呼吸暂停、高血压、体重指数、年龄、颈围和 STOP-Bang 评分≥3）、抗癫痫药物（AED）负荷＞3、抑郁（PHQ-9 评分≥10）、女性性别和夜间发作独立相关。失眠严重程度指数与抑郁和焦虑（GAD-7 评分≥7）独立相关。值得注意的是，发现了显著的性别差异。ESS 评分与男性的 OSA 相关，但与女性的抑郁相关。此外，焦虑仅与女性的失眠相关。总的来说，OSA 和抑郁分别是与日间嗜睡和失眠相关的最重要的显著临床因素。然而，在个体因素与睡眠障碍之间的关联方面存在性别差异。
