普瑞巴林单药对局灶性癫痫患者睡眠的影响

Effect of pregabalin monotherapy on sleep structure and quality of patients with focal epilepsy

目的观察抗癫痫发作药物普瑞巴林单药治疗对局灶性癫痫患者睡眠结构和睡眠质量的影响。方法收集新诊断为局灶起源的成人癫痫患者,采用普瑞巴林单药治疗,观察该药治疗前后多导睡眠-视频脑电图(Polysomnography and video-electroencephalography,PSG-VEEG)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、失眠严重指数(Insomnia severity index,ISI)及Epworth嗜睡量表(Epworth sleepiness score,ESS)评分的变化。结果普瑞巴林治疗显著改善癫痫患者的睡眠结构参数:总睡眠时间增加(P<0.001)、睡眠潜伏期减少(P<0.001)、睡眠效率提高(P<0.001)、入睡后清醒时间减少(P<0.001)、睡眠维持效率提高(P<0.001)、N3期比例增加(P<0.001)。低睡眠效率组中,86.7%的患者治疗后的睡眠效率提高到85%以上,差异具有统计学意义(P<0.01)。普瑞巴林治疗后PSQI评分明显改善(P<0.001),ISI评分显著降低(P<0.001),ESS评分无显著变化(P>0.05)。结论普瑞巴林可增加癫痫患者的慢波睡眠,提高睡眠质量,改善失眠,且不会导致日间嗜睡。

Objective To investigate the effect of anti-seizure medications(ASMs)pregabalin(PGB)monotherapy on sleep structure and quality of patients with focal epilepsy.Methods Adult patients whom newly diagnosed focal epilepsy were collected and treated with PGB monotherapy.The main outcome measures were the changes of polysomnography and video-electroencephalography(PSG-VEEG),Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI)and Epworth Sleepiness Scale(ESS)in epilepsy patients with PGB and baseline.Results PGB improved significantly sleep structural parameters,including increased total sleep time(P<0.001),decreased sleep latency(P<0.001),improved sleep efficiency(P<0.001),reduced wake time after sleep onset(P<0.001),increased sleep maintenance efficiency(P<0.001)and proportion of N3 sleep stage(P<0.001).In the group with poor sleep efficiency,86.7%of patients achieved sleep efficiency>85%after PGB treatment.The difference was statistically significant(P<0.01).PGB reduced significantly PSQI score(P<0.001)and ISI score(P<0.001).No significant change in ESS score was observed(P>0.05).Conclusions PGB could enhance slow-wave sleep(SWS),increase sleep quality and improve insomnia in patients with epilepsy without causing daytime sleepiness.