[The impact of antiepileptic therapy on sleep disorders in women with epilepsy].

I V Ponomareva, M I Karpova, E I Luzanova
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Abstract

Objective: To analyze the frequency of various sleep disorders in patients with epilepsy receiving antiepileptic therapy.

Material and methods: Sixty-four women were selected from the register of patients with epilepsy and other paroxysmal conditions. The group consisted of young and middle-aged women (36.9±13.5 years), all patients received antiepileptic therapy. To diagnose sleep disorders, we used a sequential algorithm for clinical examination supplemented by instrumental methods according to indications (polysomnography, respiratory monitoring).

Results: The duration of epilepsy was 15.7±7.6 years, the disease was represented by three forms: structural (n=15, 23.4%), genetic (n=32, 50%) and unspecified (n=17, 26.6%). Sleep disorders were common among female patients with epilepsy (43.7%), they are most frequently combined with genetic epilepsy (18.7%), and represented by: insomnia (43%) mild to moderately severe breathing disorders (32%) and sleep movement disorders (25%). Sleep disorders were combined with symptoms of depression in the majority of patients (71%). A 6-month follow-up evaluation of nighttime sleep parameters after treatment showed a decrease in the frequency of sleep disorders to 25%; scores on the Epworth Sleepiness Scale significantly decreased to 6.7±3.6. A change in antiepileptic therapy in patients with sleep breathing disorders resulted in a marked regression of the Apnea-Hypopnea Index (9.2±2.5 points; p=0.003). However, there were no significant changes in the severity of sleep movement disorders.

Conclusion: Sleep disorders are common in patients with epilepsy, in most cases they are associated with mood disorders, and may regress after optimization of antiepileptic therapy.

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[抗癫痫治疗对女性癫痫患者睡眠障碍的影响]。
目的:分析癫痫患者接受抗癫痫药物治疗后各种睡眠障碍的发生频率。材料和方法:从登记的癫痫和其他发作性疾病患者中选择64名妇女。本组为中青年女性(36.9±13.5岁),所有患者均接受抗癫痫药物治疗。为了诊断睡眠障碍,我们采用顺序算法进行临床检查,并根据适应症(多导睡眠图、呼吸监测)辅以仪器方法。结果:癫痫病程15.7±7.6年,主要表现为结构性(n=15, 23.4%)、遗传性(n=32, 50%)和非特异性(n=17, 26.6%)三种发病形式。睡眠障碍在女性癫痫患者中较为常见(43.7%),最常合并遗传性癫痫(18.7%),以失眠(43%)、轻至中重度呼吸障碍(32%)和睡眠运动障碍(25%)为代表。大多数患者(71%)伴有睡眠障碍和抑郁症状。治疗后6个月的夜间睡眠参数随访评估显示,睡眠障碍的频率下降到25%;爱普沃斯嗜睡量表得分明显下降到6.7±3.6。睡眠呼吸障碍患者抗癫痫治疗的改变导致呼吸暂停-低通气指数(9.2±2.5点)显著下降;p = 0.003)。然而,睡眠运动障碍的严重程度没有明显变化。结论:睡眠障碍在癫痫患者中较为常见,多数伴有情绪障碍,抗癫痫药物治疗优化后睡眠障碍可消退。
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来源期刊
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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