Szabó Réka, Voiță-Mekereș Florica, Tudoran Cristina, Abu-Awwad Ahmed, Tudoran Mariana, Mihancea Petru, Ilea Codrin Dan Nicolae
Department of Neurological Rehabilitation, Municipal Clinical Hospital, 410469 Oradea, Romania.
Doctoral School, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Square, 410068 Oradea, Romania.
Healthcare (Basel). 2022 Mar 21;10(3):588. doi: 10.3390/healthcare10030588.
(1) Background: Based on the premise that epilepsy is frequently associated with hypnopathies, in this study we aim to analyze the prevalence of sleep disturbances among patients with epilepsy, with exclusively or predominantly nocturnal seizures, in relation to demographic factors as well as clinical and electroencephalography (EEG) aspects. (2) Methods: 69 patients with nocturnal epilepsy were included in our study. Sleep disturbances were measured with the Pittsburgh Sleep Quality Index (PSQI) questionnaire, followed by a long-term video-EEG monitoring during sleep. We analyzed the PSQI results in relation to patients' gender and age and determined the correlations between the PSQI scores and the modifications on video-EEG recordings, in comparison to a control group of 25 patients with epilepsy but without nocturnal seizures. (3) Results: We found a statistically significant difference between the PSQI of patients with nocturnal seizures compared to those without nocturnal epileptic manifestations. In the experimental group, the mean PSQI score was 7.36 ± 3.91 versus 5.04 ± 2.56 in controls. In women, the average PSQI score was 8.26, whilst in men it only reached 6.41, highlighting a statistically significant difference between genders ( ˂ 0.01). By examining the relationships between the PSQI scores and certain sleep-related factors, evidenced on the nocturnal video-EEG, we found a statistically significant difference between PSQI values of patients who reached the N2 stage, and those who reached the N3 stage of nonrapid eye movement (NREM) sleep, highlighting that those with a more superficial nocturnal sleep also had higher PSQI scores. There were no statistically significant differences regarding the PSQI scores between patients with or without interictal epileptiform discharges, and also in the few patients with nocturnal seizures where we captured ictal activity. (4) Conclusions: we evidenced in this study a poor quality of sleep in patients with nocturnal epilepsy, mostly in women, independent of age. We observed that sleep disturbances were due to superficial and fragmented sleep with frequent microarousals, not necessarily caused by the electrical epileptiform activity.
（1）背景：基于癫痫常与睡眠障碍相关这一前提，在本研究中，我们旨在分析仅发作于夜间或主要发作于夜间的癫痫患者睡眠障碍的患病率，以及其与人口统计学因素、临床和脑电图（EEG）方面的关系。（2）方法：69例夜间癫痫患者纳入我们的研究。采用匹兹堡睡眠质量指数（PSQI）问卷测量睡眠障碍，随后在睡眠期间进行长期视频脑电图监测。我们分析了PSQI结果与患者性别和年龄的关系，并确定了PSQI评分与视频脑电图记录变化之间的相关性，与25例有癫痫但无夜间发作的对照组进行比较。（3）结果：我们发现有夜间发作的患者与无夜间癫痫表现的患者的PSQI存在统计学显著差异。在实验组中，PSQI平均评分为7.36±3.91，而对照组为5.04±2.56。女性的平均PSQI评分为8.26，而男性仅为6.41，突出显示了性别之间的统计学显著差异（˂0.01）。通过检查PSQI评分与夜间视频脑电图上显示的某些睡眠相关因素之间的关系，我们发现进入非快速眼动（NREM）睡眠N2期的患者与进入N3期的患者的PSQI值存在统计学显著差异，突出表明夜间睡眠较浅的患者PSQI评分也较高。有或无发作间期癫痫样放电的患者之间，以及在少数我们捕捉到发作期活动的夜间发作患者中，PSQI评分均无统计学显著差异。（4）结论：我们在本研究中证明，夜间癫痫患者睡眠质量较差，主要是女性，且与年龄无关。我们观察到睡眠障碍是由于睡眠浅且碎片化，伴有频繁的微觉醒，不一定由癫痫样电活动引起。
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