A Study Of Sleep Architecture And Sleep Disorders In Adult Patients With Epilepsy By Polysomnogram (PSG)

[OBJECTIVE]To analyze the manifestation and characteristics of sleep architecture and sleep disorders in patients with epilepsy by polysomnogram(PSG) and explore the characteristics of sleep architecture and sleep disorders in epilepstic patients. To study the relationship between epilepsy and sleep.[METHODS]43cases adult epilepsy patients older than16years and40cases without documented diseases of the central nerve system as controls were monitored by all night ambulatory video-polysomnographic monitoring and16channel ambulatory electroencephalograph (EEG).The epileptic patients were retrospectively divided into two groups according to the sex、epilepsy type、nocturnal epileptic activitiy、sleep apnea syndrome(SAS)、REM sleep without atonia(RWA).The parameters of sleep architecture and sleep-related events were analyzed between the different groups retrospectively.[RESULT]1、Male cases of epilepsy had an increase in total arouse time、apnea hypopnea index and hypopnea index,a decrease in sleep efficiency and the lowest SaO2when compared with female ones(P<0.05).Focal epilepsy subjects had an increase in epileptic activity when compared with generalized epilepsy subjects(P<0.05).2、Nocturnal epileptic activities were activated during NREM sleep(93.5%)and were inhibited during REM sleep(6.5%).The nocturnal epileptic activities in focal epilepsy subjects generally occur during light sleep(N133.3%,N240.5%).Compared with epilepsy subjects without nocturnal interictal epileptic discharges(IEDs),epilepsy subjects with nocturnal IEDs occurred in focal epilepsy more frequent(P＜0.05),and an increase in total sleep time(P＜0.05),a decrease in the prevalence of sleep onset insomnia(P＜0.05).3、Male cases of epilepsy had an decrease in the prevalence of SAS when compared with female ones(P<0.05).Epilepsy combined SAS subjects had a decrease in total sleep time、N1%、N2%、N3%、the number of sleep cycle、sleep efficiency,an increase in total arousal time、arousal index、AHI and the prevalence of sleep maintenance insomnia and periodic limb movement disorder(PLMD) when compared with uncombined SAS ones(P<0.05).4、Compared with control groups, epilepsy cases had an increace in the prevalence of RWA (P<0.05).Epilepsy combined RWA subjects had an increase in bedtime、sleep period time when compared with uncombined RWA ones(P＜0.05).[Conclusion]1、Male case of had an increase in total arouse time、apnea hypopnea index and hypopnea index,,a decrease in sleep efficiency and the lowest SaO2.2、Focal epilepsy patient had an increase in nocturnal epileptic activity.3、Nocturnal epileptic activities are activated during NREM sleep and are inhibited during REM sleep.The nocturnal IEDs and epileptic seizures in focal epileptic subjects generally occur during light sleep.4、The sleep architecture in epilepsy combined SAS patients had a significant change,and the prevalence of sleep maintenance insomnia and PLMD increased.5、There is a high prevalence of RWA in epilepsy patients, and bedtime、sleep period time in those people increased.