Center of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Center of Excellence for Epilepsy and Magnetoencephalography Center, Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Seizure. 2020 Nov;82:59-64. doi: 10.1016/j.seizure.2020.09.016. Epub 2020 Sep 25.
This study aims to assess the prevalence of sleep abnormalities in children with drug-resistant epilepsy (DRE) and characterize their polysomnographic profile and to further compare it with well-controlled epilepsy (WCE) and age-matched typically developing children (TDC).
A cross-sectional study consisting of 40 children in each group (DRE, WCE, and TDC) was conducted. Children's sleep habits questionnaire (CSHQ) and modified pediatric Epworth daytime sleepiness scale (MPEDSS) were administered to all three groups. Thirty-five children each in the DRE and WCE group and 17 TDC underwent single night polysomnography (PSG).
The prevalence of sleep abnormalities by the administration of CSHQ in DRE group was 72.5% (95% C.I-58.7 to 86.3%, mean score: 47.5 ± 7.1) compared to 32.5% (42.4 ± 6.2) and 15% (37.3 ± 5) in WCE and TDC groups respectively (P = 0.01). On MPEDSS, 52.5% of children in the DRE group had excessive daytime sleepiness compared to 12.5% in WCE and 5% in TDC groups respectively (p-0.03). On overnight PSG, sleep efficiency and REM sleep duration were significantly reduced in the DRE group in comparison to WCE and TDC. N2 duration, REM latency, arousal, and apnea-hypopnea index were significantly increased in the DRE group when compared to WCE and TDC groups.
Sleep-related problems are major comorbidity in up to three-fourths of patients with DRE and sleep architecture is significantly affected particularly in the DRE group.
本研究旨在评估耐药性癫痫(DRE)儿童睡眠异常的发生率,并描述其多导睡眠图特征,进一步与癫痫控制良好(WCE)和年龄匹配的正常发育儿童(TDC)进行比较。
进行了一项横断面研究,每个组(DRE、WCE 和 TDC)包含 40 名儿童。对三组儿童均进行儿童睡眠习惯问卷(CSHQ)和改良小儿 Epworth 白天嗜睡量表(MPEDSS)评估。DRE 组和 WCE 组各有 35 名儿童和 17 名 TDC 接受了单夜多导睡眠图(PSG)检查。
DRE 组通过 CSHQ 评估的睡眠异常发生率为 72.5%(95%置信区间为 58.7-86.3%,平均得分:47.5 ± 7.1),而 WCE 和 TDC 组分别为 32.5%(42.4 ± 6.2)和 15%(37.3 ± 5)(P = 0.01)。在 MPEDSS 上,DRE 组 52.5%的儿童有日间过度嗜睡,而 WCE 组和 TDC 组分别为 12.5%和 5%(p-0.03)。在整夜 PSG 中,DRE 组的睡眠效率和 REM 睡眠时间明显低于 WCE 和 TDC 组。与 WCE 和 TDC 组相比,DRE 组的 N2 持续时间、REM 潜伏期、觉醒和呼吸暂停低通气指数显著增加。
睡眠相关问题是 DRE 患者高达四分之三的主要合并症,睡眠结构受到显著影响,特别是在 DRE 组。