Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan.
Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan.
Sleep Med. 2021 May;81:101-108. doi: 10.1016/j.sleep.2021.02.007. Epub 2021 Feb 9.
OBJECTIVE/BACKGROUND: Patients with epilepsy have disrupted sleep architecture and a higher prevalence of sleep disturbance. Moreover, obstructive sleep apnea (OSA) is more common among patients with refractory epilepsy. Few studies have compared subjective sleep quality, sleep architecture, and prevalence of OSA between patients with refractory epilepsy and those with medically controlled epilepsy. Therefore, this study aimed to evaluate the differences in sleep quality, sleep architecture, and prevalence of OSA between patients with refractory epilepsy and patients with medically controlled epilepsy.
This retrospective case-control study included 38 patients with refractory epilepsy and 96 patients with medically controlled epilepsy. Sleep parameters and indices of sleep-related breathing disorders were recorded by standard in-laboratory polysomnography. The scores from sleep questionnaires on sleep quality and daytime sleepiness were compared between the two groups.
Patients with refractory epilepsy versus medically controlled epilepsy had statistically significantly decreased rapid eye movement (REM) sleep (13.5 ± 6.1% vs. 16.2 ± 6.1%) and longer REM latency (152.2 ± 84.1 min vs. 117.2 ± 61.9 min). Further, no differences were found in the prevalence of sleep-related breathing disorders, subjective sleep quality, prevalence of daytime sleepiness, and quality of life. Although not statistically significant, patients with refractory epilepsy have a lower rate of OSA compared with those with medically controlled epilepsy (21.1% vs. 30.2%).
Patients with refractory epilepsy had more disrupted REM sleep regulation than those with medically controlled epilepsy. Although patients with epilepsy have a higher risk of OSA, in this study patients with refractory epilepsy were not susceptible to OSA.
目的/背景：癫痫患者的睡眠结构受到干扰，睡眠障碍的发生率更高。此外，阻塞性睡眠呼吸暂停（OSA）在耐药性癫痫患者中更为常见。很少有研究比较耐药性癫痫患者和药物控制良好的癫痫患者的主观睡眠质量、睡眠结构和 OSA 的患病率。因此，本研究旨在评估耐药性癫痫患者和药物控制良好的癫痫患者之间睡眠质量、睡眠结构和 OSA 患病率的差异。
本回顾性病例对照研究纳入了 38 例耐药性癫痫患者和 96 例药物控制良好的癫痫患者。通过标准的实验室多导睡眠图记录睡眠参数和睡眠相关呼吸障碍指数。比较两组患者睡眠问卷的睡眠质量和白天嗜睡评分。
与药物控制良好的癫痫患者相比，耐药性癫痫患者的快速眼动（REM）睡眠明显减少（13.5±6.1%对 16.2±6.1%），REM 潜伏期延长（152.2±84.1min 对 117.2±61.9min）。此外，睡眠相关呼吸障碍的患病率、主观睡眠质量、白天嗜睡的患病率和生活质量均无差异。尽管无统计学意义，但耐药性癫痫患者的 OSA 患病率低于药物控制良好的癫痫患者（21.1%对 30.2%）。
与药物控制良好的癫痫患者相比，耐药性癫痫患者的 REM 睡眠调节更紊乱。尽管癫痫患者患 OSA 的风险较高，但在本研究中，耐药性癫痫患者不易患 OSA。
