Abstract：
OBJECTIVE: Sleep disturbances commonly reported among epilepsy patients have a reciprocal relationship with the condition; While epilepsy and anti-seizure medications (ASMs) can disrupt sleep structure, disturbed sleep can also exacerbate the frequency of seizures. This study explored subjective sleep disturbances and compared sleep profiles in patients who underwent ASM monotherapy and polytherapy.
METHODS: We enrolled 176 epilepsy patients who completed a structured questionnaire containing demographic and clinical information and the Persian versions of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Patient Health Questionnaire-9 (PHQ-9) to evaluate sleep quality, insomnia, excessive daytime sleepiness (EDS), and depressive symptoms, respectively. Chi-square and Mann-Whitney U tests were employed to analyze the association between variables, and logistic regression analysis was conducted to identify factors predicting sleep disturbances.
RESULTS: Comparative analysis of mono/polytherapy groups revealed a significantly higher prevalence of insomnia and EDS among patients on polytherapy compared to monotherapy. However, no significant difference was found in sleep quality between the two groups. Logistic regression analysis revealed that a depressive mood serves as a robust predictor for sleep issues, whereas treatment type did not emerge as an independent predictor of sleep disturbances.
CONCLUSIONS: Our findings suggest that an increased number of ASMs does not inherently result in a higher incidence of sleep issues. Therefore, multiple ASMs may be prescribed when necessary to achieve improved seizure control. Furthermore, this study underscores the importance of comprehensive management that addresses seizure control and treating affective symptoms in individuals with epilepsy.
METHODS: We enrolled 176 epilepsy patients who completed a structured questionnaire containing demographic and clinical information and the Persian versions of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Patient Health Questionnaire-9 (PHQ-9) to evaluate sleep quality, insomnia, excessive daytime sleepiness (EDS), and depressive symptoms, respectively. Chi-square and Mann-Whitney U tests were employed to analyze the association between variables, and logistic regression analysis was conducted to identify factors predicting sleep disturbances.
RESULTS: Comparative analysis of mono/polytherapy groups revealed a significantly higher prevalence of insomnia and EDS among patients on polytherapy compared to monotherapy. However, no significant difference was found in sleep quality between the two groups. Logistic regression analysis revealed that a depressive mood serves as a robust predictor for sleep issues, whereas treatment type did not emerge as an independent predictor of sleep disturbances.
CONCLUSIONS: Our findings suggest that an increased number of ASMs does not inherently result in a higher incidence of sleep issues. Therefore, multiple ASMs may be prescribed when necessary to achieve improved seizure control. Furthermore, this study underscores the importance of comprehensive management that addresses seizure control and treating affective symptoms in individuals with epilepsy.
摘要：
目的：癫痫患者中常见的睡眠障碍与病情有相互关系；而癫痫和抗癫痫药物（ASM）可以破坏睡眠结构，睡眠紊乱也会加剧癫痫发作的频率。这项研究探讨了主观睡眠障碍，并比较了接受ASM单一疗法和综合疗法的患者的睡眠状况。
方法：我们招募了176名癫痫患者，他们完成了包含人口统计学和临床信息以及匹兹堡睡眠质量指数（PSQI）的波斯版本的结构化问卷，失眠严重程度指数（ISI），Epworth嗜睡量表（ESS），和患者健康问卷-9（PHQ-9）来评估睡眠质量，失眠,白天过度嗜睡（EDS），和抑郁症状,分别。卡方检验和Mann-WhitneyU检验用于分析变量之间的关联。并进行逻辑回归分析以确定睡眠障碍的预测因素。
结果：单药/多药治疗组的比较分析显示，与单药治疗相比，多药治疗组患者失眠和EDS的患病率明显更高。然而,两组的睡眠质量无显著差异。Logistic回归分析显示，抑郁情绪是睡眠问题的有力预测因子，而治疗类型并未成为睡眠障碍的独立预测因子。
结论：我们的研究结果表明，ASM数量的增加本身并不会导致睡眠问题的发生率升高。因此,必要时可处方多种ASM以改善癫痫发作控制。此外，这项研究强调了全面管理的重要性,即控制癫痫发作和治疗癫痫患者的情感症状.
方法：我们招募了176名癫痫患者，他们完成了包含人口统计学和临床信息以及匹兹堡睡眠质量指数（PSQI）的波斯版本的结构化问卷，失眠严重程度指数（ISI），Epworth嗜睡量表（ESS），和患者健康问卷-9（PHQ-9）来评估睡眠质量，失眠,白天过度嗜睡（EDS），和抑郁症状,分别。卡方检验和Mann-WhitneyU检验用于分析变量之间的关联。并进行逻辑回归分析以确定睡眠障碍的预测因素。
结果：单药/多药治疗组的比较分析显示，与单药治疗相比，多药治疗组患者失眠和EDS的患病率明显更高。然而,两组的睡眠质量无显著差异。Logistic回归分析显示，抑郁情绪是睡眠问题的有力预测因子，而治疗类型并未成为睡眠障碍的独立预测因子。
结论：我们的研究结果表明，ASM数量的增加本身并不会导致睡眠问题的发生率升高。因此,必要时可处方多种ASM以改善癫痫发作控制。此外，这项研究强调了全面管理的重要性,即控制癫痫发作和治疗癫痫患者的情感症状.
