Wang Sihang, Wu Meina, Wu Sangru, Lin Fang, Ji Xiaolin, Yan Jinzhu
Department of Neurology and Sleep Medical Center, Fujian Provincial Governmental Hospital, Fuzhou, China.
Heliyon. 2024 Feb 10;10(4):e25904. doi: 10.1016/j.heliyon.2024.e25904. eCollection 2024 Feb 29.
The primary objective is to explore what causes slow-wave sleep loss in elderly patients with epilepsy. The secondary objective is to identify the PSG characteristics in elderly patients with epilepsy. The clinical demographics, sleep architecture, sleep-related events, and interictal epileptiform discharges are to be evaluated in the objectives.
The video electroencephalography (VEEG) and polysomnogram (PSG) data from 44 elderly patients with epilepsy and 52 elderly patients with sleep disorders but without definite central nervous system diseases were analysed. This was a case-control study. The differences in the PSG sleep architecture parameters (total sleep time (TST), sleep efficiency, wake after sleep onset, etc.) and sleep-related events (apnea hypopnea index, oxygen desaturation index (ODI), periodic limb movement index, etc.) between the epilepsy and control groups. As Additionally, these parameters were assessed within the elderly patients with epilepsy, comparing the slow-wave sleep existence and slow-wave sleep loss groups, using VEEG and PSG.
The epileptic group exhibited significantly lower TST (343.477 ± 96.3046min vs 389.115 ± 61.5727min, < 0.05), rapid eye movement (%) (13.011 ± 7.5384 vs 16.992 ± 6.7025, < 0.05), non-rapid eye movement stage 3 (%) (1.35[0,7.225] vs 3.65[0.425,13.75], < 0.05), and sleep efficiency (%) (69.482 ± 14.1771% vs 77.242 ± 10.6171%, < 0.05). Conversely, the ODI (25.6[9.825,51.775] events/hour vs 16.85[5.3,30.425] events/hour, < 0.05) and spontaneous arousal index (4.0455[2.1805,6.9609] events/hour vs 2.9709[1.4747,5.0554] events/hour, < 0.05) were significantly higher in elderly patients with epilepsy. The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) was significantly higher in the slow-wave sleep loss group than in the slow-wave sleep existence group (100% vs 77.8%, < 0.05). The incidence of slow-wave sleep loss was lower in patients with epilepsy aged between 75 and 85 years compared to those aged between 65 and 75 years.
Elderly patients with epilepsy exhibit higher levels of ODI and spontaneous arousal index. Our findings indicate that OSAHS could be a contributing factor to slow-wave sleep loss in this population. The incidence of slow-wave sleep loss was lower in patients aged above 75 years among elderly patients with epilepsy.
主要目的是探究老年癫痫患者慢波睡眠丧失的原因。次要目的是确定老年癫痫患者的多导睡眠图（PSG）特征。在这些目的中，将对临床人口统计学、睡眠结构、睡眠相关事件以及发作间期癫痫样放电进行评估。
分析了44例老年癫痫患者和52例患有睡眠障碍但无明确中枢神经系统疾病的老年患者的视频脑电图（VEEG）和多导睡眠图（PSG）数据。这是一项病例对照研究。比较癫痫组和对照组在PSG睡眠结构参数（总睡眠时间（TST）、睡眠效率、睡眠开始后觉醒等）和睡眠相关事件（呼吸暂停低通气指数、氧饱和度下降指数（ODI）、周期性肢体运动指数等）方面的差异。此外，使用VEEG和PSG对老年癫痫患者中慢波睡眠存在组和慢波睡眠丧失组的这些参数进行评估。
癫痫组的TST（343.477±96.3046分钟对389.115±61.5727分钟，P<0.05）、快速眼动（%）（13.011±7.5384对16.992±6.7025，P<0.05）、非快速眼动3期（%）（1.35[0,7.225]对3.65[0.425,13.75]，P<0.05）以及睡眠效率（%）（69.482±14.1771%对77.242±10.6171%，P<0.05）显著更低。相反，老年癫痫患者的ODI（25.6[9.825,51.775]次/小时对16.85[5.3,30.425]次/小时，P<0.05）和自发觉醒指数（4.0455[2.1805,6.9609]次/小时对2.9709[1.4747,5.0554]次/小时，P<0.05）显著更高。慢波睡眠丧失组中阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的患病率显著高于慢波睡眠存在组（100%对77.8%，P<0.05）。75至85岁的癫痫患者中慢波睡眠丧失的发生率低于65至75岁的患者。
老年癫痫患者的ODI和自发觉醒指数水平更高。我们的研究结果表明，OSAHS可能是该人群慢波睡眠丧失的一个促成因素。75岁以上的老年癫痫患者中慢波睡眠丧失的发生率较低。
