癫痫患者全夜自然睡眠结构的研究

The structure of the spontaneous all night sleep in epileptics

目的 观察癫痫患者发作间期全夜自然睡眠结构特点 ,并评价其与正常对照组睡眠结构的差异 ;评价发作类型、用药情况及是否记录到发作间电发放对睡眠结构的影响。方法 对 2 0名癫痫患者及 11名对照进行全夜自然睡眠多导监测 ,并结合患者的发作类型、是否记录到发作间电发放 (IIDs)及服用 AEDs的情况进行分组统计分析 ,评价各组患者与正常对照间各睡眠参数的差异。结果 癫痫患者组 ,记录到 IIDs组 ,及该组患者中部分性发作者和未服 AEDs者均较正常对照 TRT、RL 显著延长 (P<0 .0 5)。记录到 IIDs的患者睡眠效率显著下降 (P≤0 .0 5) ,其中部分性发作者入睡后觉醒次数较全身性发作者显著增多 (P<0 .0 5)。部分性发作者较全身性发作者NREM睡眠期转换次数有增高的趋势。不同用药癫痫患者睡眠脑电图较正常对照组睡眠破碎性增加。结论 癫痫患者与正常对照比较 RL延长 ;睡眠破碎性增加 ;记录到 IIDs的患者睡眠效率降低 ;部分性发作患者较全身性发作患者有 NREM期转换次数频繁的趋势 ;记录到 IIDs患者中服用 AEDs的情况对其睡眠结构无显著影响。

Objective To observe the characters of spontaneous s leep structure in epileptics(EP) in seizure-free night.To evaluate not only the differences of the sleep structure between EP groups and control group,but also the influences of the type of seizure,the therapy and whether IIDs were recorde d during the examination to sleep structure.Methods All night p olysomnographies were carried out on 20 epileptics and 11 healthy controls who w ere fit with the requirement of this trial.Parameters of sleep structure were ca lculated later by computer and were brought into the statistical analysis according to the seizure type,the therapy and whether there were IIDs during the examination to evaluate the differences among patient-groups and bet ween epileptics and controls.Results All epileptics,patients wi th IIDs,partial seizure epileptics with IIDs and patients with IIDs not taking A EDs had significantly longer TRT and RL than control group (P<0.05).Epileptics had a more fragmentized s leep than control group.Sleep efficiency of patients with IIDs was lower than th at of patients without IIDs (P≤0.05). Among the patients with IIDs,partial seizure epileptics had a significantly higher WASO than those with generalized s eizure (P<0.05). There was the tendency that the number of NREM stage shift in patients with part ial epilepsy was higher than that with generalized seizures.There were no signif icant differences between patients with IIDs with or without simple AEDs therapy .Conclusion Compared with controls,epileptics have sleep disturbances representing delayed R EM sleep onset and enhanced sleep fragmentation by visual analysis.Patients with IIDs had a decreased sleep efficiency comparing with those without IIDs during examination.Patients with partial epilepsy tended to have a fragmentized NREM relatively to those with generalized seizures. There is no significant influenc e of the different therapy to sleep structure in patients with IIDs.