癫痫杂志

癫痫杂志

癫痫患者睡眠障碍及其影响因素研究

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目的 研究癫痫患者常见的睡眠障碍特点及其影响因素。 方法 收集 2016 年 10 月–2017 年 10 月浙江大学附属第二医院门诊及癫痫中心住院收治的 184 例癫痫患者,详细采集临床资料并完善睡眠相关量表评定。睡眠相关评定工具:中文版匹兹堡睡眠质量指数量表、Epworth 嗜睡量表、柏林问卷、癫痫患者生活质量评定量表-31、贝克焦虑量表及贝克抑郁量表。 结果 184 例癫痫患者中,男 100 例(54.3%),女 84 例(45.7%);其中,35 例(19.0%)患者存在睡眠障碍,89 例(48.4%)生活质量较差,23 例(12.5%)合并焦虑,47 例(25.5%)合并抑郁,59 例(32.1%)易日间嗜睡,合并阻塞性睡眠呼吸暂停综合征的癫痫患者达 30 例(16.3%)。伴睡眠障碍患者较不伴睡眠障碍患者在年龄、有高血压病史、发作频率、生活质量、焦虑和抑郁方面均有统计学差异。将以上因素进行 Logistic 回归分析,提示发作频率(P=0.011)和抑郁(P<0.001)是睡眠障碍的独立危险因素。 结论 伴睡眠障碍较不伴睡眠障碍的癫痫患者的发作频率更高,生活质量更差,更易合并焦虑和抑郁,且发作频率及抑郁是癫痫患者睡眠问题的独立危险因素。

Objectives To study the characteristics and influencing factors of sleep disorder in patients with epilepsy. Methods One hundred and eighty-four patients with epilepsy who were admitted to the outpatient department and the epilepsy center in the Second Affiliated Hospital of Zhejiang University from October 2016 to October 2017 were enrolled. Their clinical data were collected in detail and their sleep related scales were evaluated. Sleep related assessment tools: Chinese version of the Pittsburgh sleep quality index scale (PSQI), the Epworth sleepiness scale (ESS), Berlin Questionnaire (BQ), Quality Of Life In People With Epilepsy-31 (QOLIE-31), Beck Anxiety Inventory (BAI) and Beck Depression Inventory(BDI). Results Among the 184 cases of patients with epilepsy, 100 cases were male (54.3%), 84 cases were female (45.7%), 35 cases (19.0%) had sleep disorders, 89 cases (48.4%) with poor quality of life, 23 cases (12.5%) with anxiety, 47 cases (25.5%) with depression, 59 cases (32.1%) had daytime sleepiness, and 30 cases (16.3%) with OSAS. there were statistically significant differences in age, history of hypertension, seizure frequency, quality of life , anxiety and depression in epilepsy patients with sleep disorder compared those without sleep disorder (P<0.05). The seizure frequency, quality of life, anxiety and depression were analyzed by logistic regression analysis, suggesting that seizure frequency (P=0.011) and depression (P<0.001) are independent risk factors of sleep disorders. Conclusions Epileptic patients with sleep disorder have higher frequency of seizures, poorer quality of life, and are more likely to be associated with anxiety and depression, and the frequency and depression are independent risk factors of sleep disorder in patients with epilepsy.

关键词: 癫痫; 睡眠障碍; 影响因素; 治疗

Key words: Epilepsy; Sleep dsorder; Influencing factors; Treatment

引用本文: 孙萌, 丁瑶, 丁美萍. 癫痫患者睡眠障碍及其影响因素研究. 癫痫杂志, 2019, 5(1): 11-15. doi: 10.7507/2096-0247.20190002 复制

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1. Crespel A, Coubes P, Baldy-Moulinier M. Sleep influence on seizures and epilepsy effects on sleep in partial frontal and temporal lobe epilepsies. Clin Neurophysiol, 2000, 111(Suppl 2): 54-59.
2. Manni R, Terzaghi M, Arbasino C, et al. Obstructive sleep apnea in a clinical series of adult epilepsy patients: frequency and features of the comorbidity. Epilepsia, 2003, 44(6): 836-840.
3. Malow BA, Levy K, Maturen K, et al. Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology, 2000, 55(7): 1002-1007.
4. Khatami R, Zutter D, Siegel A, et al. Sleep-wake habits and disorders in a series of 100adult epilepsy patients-a prospective study. Seizure, 2006, 15(5): 299-306.
5. Piperidou C, Karlovasitou A, Triantafyllou N, et al. Influence of sleep disturbance on quality of life of patients with epilepsy. Seizure, 2008, 17(7): 588-594.
6. Unterberger I, Gabelia D, Prieschl M, et al. Sleep disorders and circadian rhythm in epilepsy revisited: a prospective controlled study. Sleep Med, 2014, 16(2): 237-242.
7. Vendrame M, Yang B, Jackson S, et al. Insomnia and epilepsy: a questionnaire-based study. J Clin Sleep Med, 2013, 9(2): 141-146.
8. Derry CP, Duncan S. Sleep and epilepsy. Epilepsy Behav, 2013, 26(3): 394-404.
9. Manni R, Terzaghi M. Comorbidity between epilepsy and sleep disorders. Epilepsy Res, 2010, 90(3): 171-177.
10. Ismayilova V, Demir AU, Tezer FI. Subjective sleep disturbance in epilepsy patients at an outpatient clinic: a questionnaire-based study on prevalence. Epilepsy Res, 2015, 115: 119-125.
11. Malow BA, Bowes RJ, Lin X. Predictors of sleepiness in epilepsy patients. Sleep, 1997, 20(12): 1105-1110.
12. Haut S, Katz M, Masur J, et al. Seizures in the elderly: impact on mental status, mood, and sleep. Epilepsy Behav, 2009, 14(3): 540-544.
13. Léger D, Scheuermaier K, Philip P, et al. SF-36: quality of life in severe and mild insomniacs compared with good sleepers. Psychosom Med, 2001, 63(1): 49-55.
14. Jacoby A, Ring A, Whitehead M, et al. Exploring loss and replacement of loss for understanding the impacts of epilepsy onset: a qualitative investigation. Epilepsy Behav, 2014, 33: 59-68.
15. Rumble ME, White KH, Benca RM. Sleep disturbances in mood disorders. Psychiatr Clin North Am, 2015, 38(4): 743-759.
16. Keezer MR, Sisodiya SM, Sander JW. Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol, 2016, 15(1): 106-115.