A Study On The Clinical Features Of Patients With Focal Epilepsy Complicated With Obstructive Sleep Apnea Hypopnea

Objective:To study the clinical features and sleep structure disorders of patients with epilepsy complicated with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:63 cases with focal epilepsy who were admitted to Qianfoshan Hospital of Shandong Province neurology from January 2017 to January 2018 were randomly selected as the subject of study.The portable sleep monitor was used to monitor the sleeping of all the subjects,and the relevant scale scoring test was improved.According to the results of sleep monitoring,patients with epilepsy were divided into epilepsy combined with OSAHS group,simple epilepsy not combined with OSAHS group,and healthy control group.The incidence of OSAHS in patients with epilepsy was studied,the clinical features and sleep structure disorders of patients with epilepsy complicated with OSAHS were analyzed by comparing the age,gender,BMI,disease duration,parameters of sleep structure and scale scores among the three groups.Results:1.Among the 63 patients,except for 3 patients with intolerance.There are 14 patients(23.3%)with epilepsy met the OSAHS diagnostic criteria in 63patients with epilepsy,of which there were 9 males(64.3%)and 5 females(35.7%).2.The BMI and disease course of patients in the epilepsy combined with OSAHS group were higher than those in the simple epilepsy group,and the difference was statistically significant(P<0.05).3.The PQSI scores and ESS scores of the three groups showed similar trends:the scores of related sleep scales of patients in the epilepsy combined with OSAHS group and the simple epilepsy group were significantly higher than those in the control group,and the scores of the combined group were significantly higher than those in the simple epilepsy group,with statistically significant differences(P<0.05).4.Sleep related indicators:the total sleep time of patients in the epilepsy group was shorter than that in the control group,with statistically significant differences(P<0.05).The latency to sleep was longer in the epilepsy group than in the control group,and shorter in the epilepsy combined with OSAHS group than in the epilepsy group(P<0.05).Compared with control group,patients with epilepsy group face a more serious sleep disorder structure:unstable proportion of sleep and wake up at night significantly increases.,stable proportion of sleep and sleep efficiency decreases obviously,after the merger of sleep apnea exacerbate this situation,and statistically significant(P<0.05),but at the same time the proportion of REM sleep period between three groups did not see obvious difference(P>0.05).5.Related indicators of sleep apnea:AHI and snore frequency of patients in the epilepsy combined with OSAHS group were significantly higher than those in the other two groups,and the mean and minimum blood oxygen saturation were significantly decreased,with statistically significant differences(P<0.05).6.Heart rate:compared with the normal control group,the sleep average heart rate of patients in the epilepsy group was significantly increased(P<0.05).When combined with sleep apnea,the awake average heart rate also increased significantly(P<0.05).In terms of MEAN,SDNN,SDANN,RMSS and PNN50 related indicators of heart rate variability,the heart rate variability indicators of patients in the epilepsy combined with OSAHS group and the epilepsy group were significantly lower than those in the control group,and those in the epilepsy combined with OSAHS group were lower than those in the epilepsy group(P<0.05).At the same time,the index of heart rate variability was affected by BMI and the proportion of unstable sleep.7.As for the scale of anxiety,depression and affective disorder,the score of the scale of anxiety and depression in patients with epilepsy combined with OSAHS was higher than that in the other two groups,and the difference was statistically significant(P<0.05).Conclusion:1.The incidence of OSAHS was 23.3%in patients with epilepsy which was higher than that in the normal control group.2.Obesity and the duration of epilepsy are the main factors affecting the onset of epilepsy combined with OSAHS.3.Patients with epilepsy complicated with OSAHS suffered from more serious sleep disorders such as sleep structure variation,sleep apnea and daytime somnolence.4.The average heart rate of patients with epilepsy combined with OSAHS was significantly increased.The HRV index of epileptic patients is lower than that of the normal population,and the heart rhythm variability of epileptic patients combined with OSAHS is further aggravated,suggesting increased sympathetic excitability and decreased parasympathetic tension.5.Epilepsy patients are often accompanied by anxiety,depression and other emotional disorders,and OSAHS patients are further aggravated with emotional disorders.