Abstract：
OBJECTIVE: To determine if insomnia-related factors differ depending on the presence of depression in patients with epilepsy.
METHODS: This cross-sectional multicenter study collected data on depressive symptoms, insomnia symptoms, and excessive daytime sleepiness, which were defined as a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 10, an Insomnia Severity Index (ISI) score of ≥ 15, and an Epworth Sleepiness Scale (ESS) of ≥ 11, respectively. Further, uncontrolled seizures were defined as one or more seizures per month during antiseizure medications treatment. A stepwise logistic regression analysis was conducted, with a logistic regression with interaction terms performed to identify differences in insomnia-related factors depending on depressive symptoms.
RESULTS: Of 282 adults with epilepsy (men, 58 %; mean age, 40.4 ± 13.9 years), a PHQ-9 score ≥ 10, an ISI score ≥ 15, an ESS score ≥ 11 were noted in 23.4 % (n = 66), 20.2 % (n = 57), and 12.8 % (n = 36), respectively. More patients with depressive symptoms had an ISI score ≥ 15 (56.1 % vs. 9.3 %; p < 0.001) than those without. In multiple logistic regression, uncontrolled seizures (odds ratio [OR], 4.896; p < 0.01), daytime sleepiness (OR, 5.369; p < 0.05), and a history of psychiatric disorders (OR, 3.971; p < 0.05) were identified as significant factors that were more likely to be associated with an ISI score ≥ 15; however, this was only true in patients without depressive symptoms. In contrast, use of perampanel (OR, 0.282; p < 0.05) was less likely associated, while female sex (OR, 3.178; p < 0.05) was more likely associated with an ISI score ≥ 15 only in patients with depressive symptoms.
CONCLUSIONS: Insomnia-related factors in patients with epilepsy may differ between patients with and without depression. Our findings of different insomnia-related factors based on the presence of depression may facilitate the management of patients with epilepsy.
METHODS: This cross-sectional multicenter study collected data on depressive symptoms, insomnia symptoms, and excessive daytime sleepiness, which were defined as a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 10, an Insomnia Severity Index (ISI) score of ≥ 15, and an Epworth Sleepiness Scale (ESS) of ≥ 11, respectively. Further, uncontrolled seizures were defined as one or more seizures per month during antiseizure medications treatment. A stepwise logistic regression analysis was conducted, with a logistic regression with interaction terms performed to identify differences in insomnia-related factors depending on depressive symptoms.
RESULTS: Of 282 adults with epilepsy (men, 58 %; mean age, 40.4 ± 13.9 years), a PHQ-9 score ≥ 10, an ISI score ≥ 15, an ESS score ≥ 11 were noted in 23.4 % (n = 66), 20.2 % (n = 57), and 12.8 % (n = 36), respectively. More patients with depressive symptoms had an ISI score ≥ 15 (56.1 % vs. 9.3 %; p < 0.001) than those without. In multiple logistic regression, uncontrolled seizures (odds ratio [OR], 4.896; p < 0.01), daytime sleepiness (OR, 5.369; p < 0.05), and a history of psychiatric disorders (OR, 3.971; p < 0.05) were identified as significant factors that were more likely to be associated with an ISI score ≥ 15; however, this was only true in patients without depressive symptoms. In contrast, use of perampanel (OR, 0.282; p < 0.05) was less likely associated, while female sex (OR, 3.178; p < 0.05) was more likely associated with an ISI score ≥ 15 only in patients with depressive symptoms.
CONCLUSIONS: Insomnia-related factors in patients with epilepsy may differ between patients with and without depression. Our findings of different insomnia-related factors based on the presence of depression may facilitate the management of patients with epilepsy.
摘要：
目的：确定失眠相关因素是否因癫痫患者抑郁的存在而有所不同。
方法：这项横断面多中心研究收集了抑郁症状的数据，失眠症状,白天过度嗜睡，分别定义为患者健康问卷-9（PHQ-9）评分≥10，失眠严重程度指数（ISI）评分≥15和Epworth嗜睡量表（ESS）≥11。Further,不受控制的癫痫发作定义为在抗癫痫药物治疗期间每月一次或多次癫痫发作。进行了逐步逻辑回归分析，通过使用相互作用项进行的逻辑回归来确定取决于抑郁症状的失眠相关因素的差异。
结果：282例成人癫痫患者（男性，58%；平均年龄，40.4±13.9年)，PHQ-9评分≥10，ISI评分≥15，ESS评分≥11的占23.4％（n=66），20.2%(n=57)，和12.8%(n=36)，分别。更多抑郁症状患者的ISI评分≥15(56.1%vs.9.3%；p<0.001)比没有的高。在多元逻辑回归中，不受控制的癫痫发作(比值比[OR]，4.896;p<0.01)，白天嗜睡（或，5.369；p<0.05），和精神病史（或，3.971;p<0.05)被确定为更可能与ISI评分≥15相关的显著因素；然而，这只适用于没有抑郁症状的患者。相比之下,使用perampanel（或，0.282；p<0.05)不太可能相关，而女性（或，3.178；p<0.05）仅在有抑郁症状的患者中更可能与ISI评分≥15相关。
结论：癫痫患者的失眠相关因素在有抑郁症和无抑郁症患者之间可能存在差异。我们基于抑郁症的存在对不同失眠相关因素的发现可能有助于癫痫患者的治疗。
方法：这项横断面多中心研究收集了抑郁症状的数据，失眠症状,白天过度嗜睡，分别定义为患者健康问卷-9（PHQ-9）评分≥10，失眠严重程度指数（ISI）评分≥15和Epworth嗜睡量表（ESS）≥11。Further,不受控制的癫痫发作定义为在抗癫痫药物治疗期间每月一次或多次癫痫发作。进行了逐步逻辑回归分析，通过使用相互作用项进行的逻辑回归来确定取决于抑郁症状的失眠相关因素的差异。
结果：282例成人癫痫患者（男性，58%；平均年龄，40.4±13.9年)，PHQ-9评分≥10，ISI评分≥15，ESS评分≥11的占23.4％（n=66），20.2%(n=57)，和12.8%(n=36)，分别。更多抑郁症状患者的ISI评分≥15(56.1%vs.9.3%；p<0.001)比没有的高。在多元逻辑回归中，不受控制的癫痫发作(比值比[OR]，4.896;p<0.01)，白天嗜睡（或，5.369；p<0.05），和精神病史（或，3.971;p<0.05)被确定为更可能与ISI评分≥15相关的显著因素；然而，这只适用于没有抑郁症状的患者。相比之下,使用perampanel（或，0.282；p<0.05)不太可能相关，而女性（或，3.178；p<0.05）仅在有抑郁症状的患者中更可能与ISI评分≥15相关。
结论：癫痫患者的失眠相关因素在有抑郁症和无抑郁症患者之间可能存在差异。我们基于抑郁症的存在对不同失眠相关因素的发现可能有助于癫痫患者的治疗。
