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.
方法:我们对癫痫患者进行了横断面研究,在2017年9月至2018年12月期间连续招募。患者被分类为具有良好的癫痫发作控制(在过去4周内没有癫痫发作)或较差的癫痫发作控制(在过去4周内至少有一次癫痫发作)。我们对人口统计学和临床数据进行了组间比较,失眠(失眠严重程度指数[ISI]),白天过度嗜睡(Epworth嗜睡量表[ESS]),睡眠质量(匹兹堡睡眠质量指数[PSQI]),抑郁症(贝克抑郁量表-II[BDI-II]),和生活质量(癫痫生活质量量表-10[QOLIE-10])。
结果:样本共包括123名患者,其中31.7%的人白天嗜睡过度(ESS≥10),50.4%有失眠(ISI≥10),53.6%的人睡眠质量差(PSQI≥5)。根据我们的多变量分析,癫痫发作的存在与失业相关(比值比[OR]=4.7;95%置信区间[CI],1.36-19.2;P=.02),抗癫痫药物的数量较高(OR=5.87;95%CI,1.81-27.1;P<.001),失眠(OR=1.9;95%CI,1.1-9.3;P=0.04),睡眠质量差(OR=2.8;95%CI,1.9-10.32;P=0.01)。
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良有关。这些发现支持以下假设:睡眠障碍构成了癫痫的重要共病,尤其是癫痫控制不佳的患者。