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失眠和睡眠质量差与癫痫患者的癫痫发作控制不良有关。

Insomnia and poor sleep quality are associated with poor seizure control in patients with epilepsy.

机构信息

Departamento de Neurociencias, Hospital Germans Trias i Pujol, Badalona, Spain.

Departamento de Neurociencias, Hospital Germans Trias i Pujol, Badalona, Spain.

出版信息

Neurologia (Engl Ed). 2022 Oct;37(8):639-646. doi: 10.1016/j.nrleng.2019.07.008. Epub 2021 Oct 12.

Abstract

OBJECTIVE

This study aimed to assess the presence of sleep disorders in patients with epilepsy and to analyse their association with seizure control.

METHODS

We performed a cross-sectional study of patients with epilepsy, recruited consecutively between September 2017 and December 2018. Patients were classified as having good seizure control (no seizures in the last 4 weeks) or poor seizure control (at least one seizure in the last 4 weeks). We performed intergroup comparisons for demographic and clinical data, insomnia (Insomnia Severity Index [ISI]), excessive daytime sleepiness (Epworth Sleepiness Scale [ESS]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), depression (Beck Depression Inventory-II [BDI-II]), and quality of life (Quality of Life in Epilepsy Inventory-10 [QOLIE-10]).

RESULTS

The sample included a total of 123 patients, of whom 31.7% had excessive daytime sleepiness (ESS ≥ 10), 50.4% had insomnia (ISI ≥ 10), and 53.6% had poor sleep quality (PSQI ≥ 5). According to our multivariate analysis, presence of seizures was associated with unemployment (odds ratio [OR] = 4.7; 95% confidence interval [CI], 1.36-19.2; P = .02), a higher number of antiepileptic drugs (OR = 5.87; 95% CI, 1.81-27.1; P < .001), insomnia (OR = 1.9; 95% CI, 1.1-9.3; P = .04), and poor sleep quality (OR = 2.8; 95% CI, 1.9-10.32; P = .01).

CONCLUSIONS

Sleep disorders are common in patients with epilepsy. Insomnia and poor sleep quality were associated with poor seizure control. These findings support the hypothesis that sleep disorders constitute a significant comorbidity of epilepsy, especially in patients with poor seizure control.

摘要

目的

本研究旨在评估癫痫患者睡眠障碍的发生情况,并分析其与癫痫发作控制的关系。

方法

我们进行了一项横断面研究,连续招募了 2017 年 9 月至 2018 年 12 月间的癫痫患者。患者分为癫痫发作控制良好(过去 4 周内无发作)或癫痫发作控制不佳(过去 4 周内至少有一次发作)。我们对人口统计学和临床数据、失眠(失眠严重程度指数 [ISI])、日间嗜睡(Epworth 嗜睡量表 [ESS])、睡眠质量(匹兹堡睡眠质量指数 [PSQI])、抑郁(贝克抑郁量表-II [BDI-II])和生活质量(癫痫患者生活质量量表-10 [QOLIE-10])进行了组间比较。

结果

该样本共包括 123 名患者,其中 31.7%有日间嗜睡(ESS≥10),50.4%有失眠(ISI≥10),53.6%睡眠质量差(PSQI≥5)。根据我们的多变量分析,癫痫发作与失业(优势比 [OR] = 4.7;95%置信区间 [CI],1.36-19.2;P =.02)、抗癫痫药物数量较多(OR = 5.87;95% CI,1.81-27.1;P <.001)、失眠(OR = 1.9;95% CI,1.1-9.3;P =.04)和睡眠质量差(OR = 2.8;95% CI,1.9-10.32;P =.01)有关。

结论

睡眠障碍在癫痫患者中很常见。失眠和睡眠质量差与癫痫发作控制不佳有关。这些发现支持了睡眠障碍是癫痫的一个重要合并症的假说,尤其是在癫痫发作控制不佳的患者中。

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