学龄期癫痫儿童睡眠问题及其影响因素分析

On sleep problems in school-aged children with epilepsy and its influence factors

目的探讨原发性或可能症状性学龄期癫痫儿童的睡眠问题及其相关影响因素。方法采用中文版儿童睡眠习惯问卷(CSHQ)对54例学龄期(7~12周岁)原发性和可能症状性癫痫儿童及54例性别、年龄严格匹配的学龄期健康儿童进行调查。结果癫痫组在CSHQ总分及8个层面中的6个(睡眠抵触、入睡潜伏期、睡眠焦虑、夜醒、异态睡眠、白天嗜睡)得分与对照组相比差异有统计学意义(P<0.05)。在癫痫组中,不同年龄段CSHQ总分及睡眠抵触、入睡潜伏期、睡眠持续时间、睡眠焦虑4个层面相比差异有统计学意义(P<0.05);发作控制组和未控制组在CSHQ总分及除入睡潜伏期层面的其他层面差异均有统计学意义(P<0.05);不同发作频率CSHQ总分及除睡眠呼吸障碍层面的其他层面差异均有统计学意义(P<0.05);不同发作类型CSHQ总分和睡眠抵触、睡眠持续时间、睡眠焦虑、白天嗜睡4个层面相比差异有统计学意义(P<0.05);不同发作时间段CSHQ总分及睡眠抵触、入睡潜伏期、睡眠持续时间、睡眠焦虑、夜醒层面5个层面相比差异有统计学意义(P<0.05);单药治疗组和多药治疗组CSHQ总分和入睡潜伏期、夜醒、异态睡眠、白天嗜睡4个层面差异有统计学意义(P<0.05)。多元线性回归分析显示,性别、年龄、控制与否、发作频率、发作类型、发作时间段、抗癫痫药物种类是CSHQ总分或其某些层面分数的主要影响因素。结论癫痫患儿较健康儿童更易出现睡眠问题,其睡眠问题的发生可能与多种因素相关。

Objective To investigate the sleep problems and related affecting factors of primary or possibly symptomatic school-aged children with epilepsy. Methods 54 epilepsy children（7 to 12 years old） and the general 54 healthy children whose gender and age were strictly matched with epilepsy group were investigated by using the chinese version of CSHQ. Results ① The total CSHQ score and 6 subscale scores（bedtime resistance,sleep onset delay,sleep anxiety,night wakings,parasomnias,and daytime sleepiness） were significantly higher in the epilepsy group（P〈0. 05）. ② In the epilepsy group,different age groups had statistical difference in the total CSHQ score and 4 subscale scores（sleep resistance,sleep onset delay,sleep duration and sleep anxiety）（P〈0. 05）. The seizure controlled group and the uncontrolled group had statistical difference in the total CSHQ score and all subscale scores,except sleep onset delay（P〈0. 05）. There were statistically significant differences in the total CSHQ score and all subscale scores,except sleep-disordered breathing in different seizure frequency groups（P〈0. 05）. Different seizure type groups had statistical difference in the total CSHQ score and 4 subscale scores（sleep resistance,sleep duration,sleep anxiety and daytime sleepiness）（P〈0. 05）. Different seizure time groups had statistical difference in the total CSHQ score and 5 subscale scores（sleep resistance,sleep onset delay,sleep duration,sleep anxiety and night waking）（P〈0. 05）. Monotherapy group and polytherapy group had statistical difference in the total CSHQ score and 4 subscale scores（sleep onset delay,night waking,parasomnias and daytime sleepiness）（P〈0. 05）. ③ Multiple linear regression analysis showed that the main influencing factors of the total CSHQ score and some subscale scores were gender,age,control of seizure,frequency of seizure,type of seizure,time of seizure and the number of drug taking. Conclusion Children with epilepsy compared with healthy children are more likely to have sleep problems,and the occurrence of sleep problems may be related to many factors.