| BackgroundEpilepsy is a kind of chronic brain disease characterized by persistent epileptic tendency,with different etiological bases and different clinical manifestations,but with repeated seizures as the common feature.Epilepsy has a high incidence rate,which will bring great influence to individuals,families and society.Around the world,epilepsy have attracted much attention,and has been listed as a key mental and neurological disease to be prevented and treated.Sleep disorder is also a common disease in children,which has a serious impact on children’s study and life.Compared with non-epileptic children,children with epilepsy have a higher risk of sleep disorder.As can be seen,seizures can cause sleep disorders,and sleep disorders can also affect the control of seizures.ObjectiveTo explore the effect of effective control of sleep disorders on the curative effect of epilepsy,and to provide reference for the treatment of epilepsy in children.MethodsFrom March 2020 to March 2022,62 children with epilepsy and sleep disorders who were treated in the Pediatric Neurology and Rehabilitation Department and Epilepsy Center of the First People’s Hospital of Shangqiu.Grouped by random number table method,31 children were selected as the observation group,they were given conventional anti Seizure medications(ASMs)treatment,sodium valproate tablets,and corresponding sleep correction interventions were given according to the etiology of the children,such as:good sleep hygiene,isotopic For children with obstructive sleep apnea syndrome,pressure titration and polysomnography should be given to determine the appropriate positive end-expiratory pressure before treatment,and continuous positive airway pressure should be used throughout the sleep cycle.Children with insomnia and mild-to-moderate sleep disorders were given cognitive behavioral therapy.31 children were in the reference group,only given conventional antiepileptic drugs and sodium valproate tablets.Both groups were continuously treated for 18 months.1.The Children’s Sleep Habits Questionnaire(CSHQ)was used to evaluate the sleep disorder of the enrolled children.2.The sleep quality of the children in the two groups was evaluated by polysomnographic sleep monitor.The evaluation indicators included the number of nighttime awakenings,sleep latency,the proportion of REM sleep periods,REM sleep latency,total sleep time,and sleep efficiency.3.After treatment,the mean frequency of seizures,duration of seizures,and the time from effective dose of monotherapy to seizure cessation in the two groups were recorded.4.EEG examinations were given to the two groups of children,including the degree of abnormal EEG and brain Electrographic epilepsy wave distribution evaluation.5.Before and after treatment,the two groups of children were given the Screening Scale for Attention Deficit Hyperactivity Disorder(SNAP-IV)and the Wechsler Children’s Intelligence Scale.6.Indicators of oxidative stress:Before and after treatment 5 ml of cubital venous blood was used to detect lipid peroxide(P-LPO)and malondialdehyde(MDA)levels in the two groups by colorimetry;superoxide dismutase(SOD)levels were detected by xanthine oxidation method.7.Enzyme-linked immunosorbent assay was used to detect Adsorption method was used to detect the levels of excitatory neurotransmitters: 5-hydroxytryptamine(5-HT),glutamate(GLU),and acetylcholine(Ach),and inhibitory neurotransmitters: amino acid neurotransmitter γ-aminobutyric acid(GABA),alanine(Ala),glycine(Gly)levels.8.detection of neurological function indicators: radioimmunoassay was used to measure neuropeptide(NPY),galanin(GAL)levels;enzyme-linked immunosorbent assay was used to detect neuron Specific enolase(NSE)levels.Results1.Sleep structure: After treatment,the sleep latency and REM sleep latency of the observation group were shorter than those of the reference group(P<0.05),the proportion of REM sleep and sleep efficiency of the observation group are higher than those of the reference group(P<0.05).The total sleep time of the children in the group was longer than that in the reference group(P<0.05),and the number of nighttime awakenings in the observation group was less than that in the reference group(P<0.05).2.Sleep disorder:At the 6th,12 th and 18 th month of treatment,the CSHQ score of the observation group was lower than that of the reference group(P<0.05).3.The mean frequency of seizures,duration of seizures and time from effective dose of monotherapy to seizure cessation in the observation group were lower than those in the reference group(P<0.05).4.EEG examination: The abnormal degree of electroencephalogram and the score of epileptic wave seizure in the observation group were lower than those in the reference group(P<0.05).5.The FIQ,VIQ,and PIQ of the children in the observation group were higher than those in the reference group(P<0.05),and the SNAP-IV scores of the children in the observation group were lower than those in the reference group(P<0.05).6.Oxidative stress index: After treatment,the level of SOD in the observation group was higher than that in the reference group(P<0.05),the levels of P-LPO and MDA in the observation group were lower than those in the reference group(P<0.05).7.Neurotransmitter index:The levels of 5-HT,Glu and Ach in the observation group were lower than those in the reference group group(P<0.05),the levels of Ala,Gly and GABA in the observation group were higher than those in the reference group(P<0.05).8.The levels of NPY and GAL in the observation group were higher than those in the reference group(P<0.05),and the level of NSE in the observation group was lower than that in the reference group(P<0.05).ConclusionEffective correction and control of sleep disorders in children with epilepsy can improve sleep quality,reduce seizure frequency,reduce the time required for complete seizure control,correct EEG abnormalities,reduce EEG seizures,and improve children’s cognitive function and attention,inhibit oxidative stress,correct neurotransmitter abnormalities,and reduce nerve damage. |
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