睡眠期癫痫患者的睡眠状况调查

A survey of sleep condition in patients with pure sleep-related epilepsy

目的：本文拟分析仅在睡眠中发作的癫痂患者的临床表现及睡眠特点，并对存在睡眠不佳主诉的患者进行睡眠相关量表评定，以评价睡眠中癫痫发作与其睡眠情况的相互关系。方法：对仅在睡眠中发作的癫痫患者进行病史及睡眠习惯询问，并对其中睡眠欠佳者完成Athens慢性失眠量表（Athenschronicinsomniascale，A1S）、Pittsburgh睡眠质量指数（Pittsburghsleepqualityindex，PSQI）、Epworth嗜睡量表（EpworthsleePinessSCale，ESS）、焦虑自评量表（self_ratinganxletyscale，SAS）及抑郁自评量表（self-ratingdepressionscale，SDS）等量表评定。结果：门诊连续就诊的889例癫痫患者中，共有睡眠期发作的癫痫患者283例，占所有癫痫患者的比例为31．83％。睡眠期发作癫痢患者上床睡觉时间中位数为22点，0点之前就寝者占91．17％，8点之前起床者占86．93％。入睡所需时间超过30分钟者占21．91％，睡眠期间清醒时间超过30分钟者占7．77％，睡眠效率低于85％者占18．73％，睡眠质量差者占13．07％。白天感觉困倦者占47．35％，感觉精力不足者占30．39％。34例睡眠不佳患者完成了量表评定，其中Ais≥7分者占50．00％，PsQI≥8分者占47．06％。ESS≥11分者占14．71％。SAS≥50分者占26．47％，SDS≥50分者占41．18％。结论：睡眠期发作癫痫患者睡眠作息习惯较好，但部分存在入睡困难、睡眠持续性差、睡眠效率低下及睡眠质量不高等问题，这导致较多患者感觉白天困倦或精力不足；有睡眠不佳主诉的患者量表评定结果提示，一半左右存在睡眠量表评分异常，而白天过度嗜睡的现象较少存在，部分患者伴发抑郁及焦虑。

Objective：To analyze the characteristics of clinical manifestations and sleep state in pa- tients with epilepsy who only had seizure during sleep, and use sleep related rating scale to evaluate pa- tients who had complaint about poor sleep, to assess the relationship between seizure during sleep and sleep state. Methods：Patients who only had seizure during sleep underwent interviews about medical history, and sleep customs, and the poor sleepers finished the Athens Chronic Insomnia Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Self-rating Anxiety Scale and SelVrating Depression Scale which was related to sleep state. Results： There were 283 patients who only had seizure during sleep out of 889 out-patients with epilepsy who continuously visited our clinic. Patients who only had seizure during sleep accounted for 31.83%. Median of sleep time of these patients was 22 ： 00. Patients who went to bed before 00 ：00 accounted for 91. 17%, and patients who got up before 8 ：00 accounted for 86.93 %. Patients whose sleep onset time was over 30 minutes accounted for 21.91%, and patients who kept awake over 30 minutes during sleep accounted for 7.77 %. Patients whose sleep efficiency was less than 85% accounted for 18.73%, and patients whose sleep quality was low accounted for 13.07%. Pa- tients who felt daytime sleepiness accounted for47.35 %, and patients who felt lack of energy accountedfor 30. 39%. 34 poor sleepers completed the scales. Patients with AIS score over 7 accounted for 50.00%. Patients with PSQI over 8 accounted for 47.06%. Patients with ESS over 11 accounted for 14.71%. Patients with SAS over 50 accounted for 26. 47%. Patients with SDS over 50 accounted for 41.18%. Conclusion：Patients who only have seizure during sleep have good sleep habits, but some of them have lead problems such as difficulty, in falling asleep or maintaining sleep, low sleep efficiency and quality, which feel to high propotion of patients who need a nap during the day, and that many patients felt daytime sleepiness or lack of energy. Results from the sleep related rating scale show that about half of the patients have abnormal sleep scale score, but excessive daytime sleepiness was rare. Some patients suffer from melancholia and anxiety.