Gagliano Laura, Ding Tian Yue, Toffa Denahin H, Beauregard Laurence, Robert Manon, Lesage Frédéric, Sawan Mohamad, Nguyen Dang K, Bou Assi Elie
Institute of Biomedical Engineering and the Department of Electrical Engineering, Polytechnique Montréal, Montreal, QC, Canada.
Centre de Recherche du Centre Hospitalier de L'Université de Montréal (CRCHUM), Montreal, QC, Canada.
Front Neurol. 2023 Jan 11;13:1089094. doi: 10.3389/fneur.2022.1089094. eCollection 2022.
While it is known that poor sleep is a seizure precipitant, this association remains poorly quantified. This study investigated whether seizures are preceded by significant changes in sleep efficiency as measured by a wearable equipped with an electrocardiogram, respiratory bands, and an accelerometer.
Nocturnal recordings from 47 people with epilepsy hospitalized at our epilepsy monitoring unit were analyzed (304 nights). Sleep metrics during nights followed by epileptic seizures (24 h post-awakening) were compared to those of nights which were not.
Lower sleep efficiency (percentage of sleep during the night) was found in the nights preceding seizure days ( < 0.05). Each standard deviation decrease in sleep efficiency and increase in wake after sleep onset was respectively associated with a 1.25-fold (95 % CI: 1.05 to 1.42, < 0.05) and 1.49-fold (95 % CI: 1.17 to 1.92, < 0.01) increased odds of seizure occurrence the following day. Furthermore, nocturnal seizures were associated with significantly lower sleep efficiency and higher wake after sleep onset ( < 0.05), as well as increased odds of seizure occurrence following wake (OR: 5.86, 95 % CI: 2.99 to 11.77, < 0.001).
Findings indicate lower sleep efficiency during nights preceding seizures, suggesting that wearable sensors could be promising tools for sleep-based seizure-day forecasting in people with epilepsy.
虽然已知睡眠不佳是癫痫发作的诱因，但这种关联仍未得到很好的量化。本研究调查了癫痫发作之前，睡眠效率是否会通过配备心电图、呼吸带和加速度计的可穿戴设备测量出现显著变化。
分析了在我们癫痫监测单元住院的47名癫痫患者的夜间记录（共304个夜晚）。将癫痫发作后（觉醒后24小时）夜间的睡眠指标与未发作夜晚的睡眠指标进行比较。
在癫痫发作前的夜晚发现睡眠效率较低（夜间睡眠百分比）（<0.05）。睡眠效率每降低一个标准差以及睡眠开始后觉醒增加，第二天癫痫发作的几率分别增加1.25倍（95%置信区间：1.05至1.42，<0.05）和1.49倍（95%置信区间：1.17至1.92，<0.01）。此外，夜间癫痫发作与显著更低的睡眠效率和更高的睡眠开始后觉醒相关（<0.05），以及觉醒后癫痫发作的几率增加（比值比：5.86，95%置信区间：2.99至11.77，<0.001）。
研究结果表明癫痫发作前的夜晚睡眠效率较低，这表明可穿戴传感器可能是预测癫痫患者癫痫发作日的有前景的工具。
