Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States.
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States.
Epilepsy Behav. 2021 Sep;122:108194. doi: 10.1016/j.yebeh.2021.108194. Epub 2021 Jul 10.
Epilepsy is associated with a high prevalence of sleep disturbance. However, population-based studies on the burden of sleep disturbance in people with epilepsy are limited. This study assessed sleep duration and sleep quality by epilepsy status in the general U.S. adult population aged ≥ 18 years.
We pooled data of cross-sectional National Health Interview Surveys in 2013, 2015, and 2017 to compare the prevalence of sleep duration and quality among those without epilepsy (N = 93,126) with those with any epilepsy (a history of physician-diagnosed epilepsy) (N = 1774), those with active epilepsy (those with a history of physician-diagnosed epilepsy who were currently taking medication to control it, had one or more seizures in the past year, or both) (N = 1101), and those with inactive epilepsy (those with a history of physician-diagnosed epilepsy who were neither taking medication for epilepsy nor had had a seizure in the past year) (N = 673). We also compared these measures between those with active and those with inactive epilepsy. The prevalences were adjusted for sociodemographics, behaviors, and health covariates, with multivariable logistic regression. We used Z-tests to compare prevalences of sleep duration and quality at the statistical significance level of 0.05.
Adults with any epilepsy reported significantly higher adjusted prevalences of short sleep duration (<7 h) (36.0% vs. 31.8%) and long sleep duration (>9 h per day) (6.7% vs. 3.7%) but a lower prevalence of healthy sleep duration (7-9 h per day) (57.4% vs.64.6%) than those without epilepsy. In the past week, adults with any epilepsy reported significantly higher adjusted prevalences than adults without epilepsy of having trouble falling asleep (25.0% vs. 20.3%), staying asleep (34.4% vs. 26.3%), nonrestorative sleep (adults did not wake up feeling well rested) (≥3days) (50.3% vs. 44.3%), and taking medication to help themselves fall asleep or stay asleep (≥1 times) (20.9% vs. 13.5%). However, adults with active epilepsy did not differ from adults with inactive epilepsy with respect to these sleep duration and quality measures.
Adults with epilepsy reported more short or long sleep duration and worse sleep quality than those without epilepsy. Neither seizure occurrence nor antiepileptic drug use accounted for these differences in sleep duration and quality. Careful screening for sleep complaints as well as identifying and intervening on the modifiable risk factors associated with sleep disturbances among people with epilepsy could improve epilepsy outcomes and quality of life.
癫痫与睡眠障碍的高患病率相关。然而，关于癫痫患者睡眠障碍负担的基于人群的研究有限。本研究评估了美国≥18 岁一般成年人群中按癫痫状态划分的睡眠持续时间和睡眠质量。
我们汇总了 2013 年、2015 年和 2017 年全国健康访谈调查的横断面数据，比较了无癫痫（N=93126）与任何癫痫（有医生诊断的癫痫病史）（N=1774）、活动性癫痫（有医生诊断的癫痫病史，目前正在服用药物控制，过去一年有一次或多次发作，或两者兼有）（N=1101）和非活动性癫痫（有医生诊断的癫痫病史，既未服用癫痫药物，过去一年也无发作）（N=673）人群的睡眠持续时间和睡眠质量的患病率。我们还比较了活动性癫痫和非活动性癫痫患者之间这些措施的差异。采用多变量逻辑回归，对社会人口统计学、行为和健康相关因素进行调整。我们使用 Z 检验在统计学显著水平 0.05 比较睡眠持续时间和睡眠质量的患病率。
任何癫痫的成年人报告的短睡眠时间（<7 小时）（36.0% vs. 31.8%）和长睡眠时间（>9 小时/天）（6.7% vs. 3.7%）的调整后患病率明显更高，但健康睡眠时间（7-9 小时/天）（57.4% vs. 64.6%）的患病率较低。在过去一周，任何癫痫的成年人报告入睡困难（25.0% vs. 20.3%）、睡眠维持困难（34.4% vs. 26.3%）、非恢复性睡眠（成年人醒来后感觉休息不好）（≥3 天）（50.3% vs. 44.3%）和服用药物帮助入睡或保持睡眠（≥1 次）（20.9% vs. 13.5%）的调整后患病率明显高于无癫痫的成年人。然而，活动性癫痫与非活动性癫痫患者在这些睡眠持续时间和质量指标上没有差异。
与无癫痫的成年人相比，癫痫患者报告的短睡眠时间或长睡眠时间和较差的睡眠质量更多。发作的发生或抗癫痫药物的使用都不能解释这些睡眠持续时间和质量的差异。对癫痫患者的睡眠问题进行仔细筛查，以及识别和干预与睡眠障碍相关的可改变的风险因素，可能会改善癫痫的预后和生活质量。
