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Tytuł pozycji:

Subjective and objective hypersomnia highly prevalent in adults with epilepsy.

Tytuł:
Subjective and objective hypersomnia highly prevalent in adults with epilepsy.
Autorzy:
Grigg-Damberger M; Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM, United States of America.
Andrews N; Department of Neurology, Sleep Disorders and Epilepsy Centers, Cleveland Clinic, Cleveland, OH, United States of America.
Wang L; Cleveland Clinic Quantitative Health Sciences, Cleveland, OH, United States of America.
Bena J; Cleveland Clinic Quantitative Health Sciences, Cleveland, OH, United States of America.
Foldvary-Schaefer N; Department of Neurology, Sleep Disorders and Epilepsy Centers, Cleveland Clinic, Cleveland, OH, United States of America. Electronic address: .
Źródło:
Epilepsy & behavior : E&B [Epilepsy Behav] 2020 May; Vol. 106, pp. 107023. Date of Electronic Publication: 2020 Mar 23.
Typ publikacji:
Journal Article; Observational Study
Język:
English
Imprint Name(s):
Original Publication: San Diego, CA : Academic Press, c2000-
MeSH Terms:
Diagnostic Self Evaluation*
Sleepiness*
Disorders of Excessive Somnolence/*diagnosis
Disorders of Excessive Somnolence/*psychology
Epilepsy/*psychology
Adult ; Cross-Sectional Studies ; Disorders of Excessive Somnolence/epidemiology ; Epilepsy/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography/methods ; Prevalence ; Prospective Studies ; Sleep/physiology ; Wakefulness/physiology
Contributed Indexing:
Keywords: Daytime sleepiness; Epworth Sleepiness Scale; Maintenance of wakefulness test; Multiple sleep latency test; Polysomnography; Quality of life
Entry Date(s):
Date Created: 20200328 Date Completed: 20210118 Latest Revision: 20210118
Update Code:
20240105
DOI:
10.1016/j.yebeh.2020.107023
PMID:
32213453
Czasopismo naukowe
Introduction: Sleepiness is among the most common complaints of people with epilepsy, but objective documentation is lacking. We systematically investigated subjective and objective sleepiness in an observational cross-sectional cohort of adults with epilepsy (AWE).
Methods: This is a prospective study of AWE consecutively recruited without foreknowledge of sleep/wake complaints. Polysomnography (PSG) with 18-channel electroencephalography (EEG) followed by multiple sleep latency testing (MSLT) was performed. Patients completed the Epworth Sleepiness Scale (ESS), a single-item question assessing excessive daytime sleepiness (EDS), and a 7-day sleep and seizure diary. Multivariable linear models were used to assess the association between MSLT mean sleep latency (MSL) and interests with adjustment of covariates of interest. Receiver operating characteristics (ROC) analysis was performed to evaluate the discrimination capability of ESS on MSL < 8 min and <5 min and investigate the optimal cutpoints.
Results: Among 127 AWE (mean age: 38.7 ± 13.7 years), abnormal MSL (<8 min) was observed in 49.6% and MSL <5 min in 31.5%. While 78% reported feeling sleepy during the day on a single-item question, only 24% had elevated scores on the ESS (>10/24). The ESS score was associated with MSL even after adjusting for seizure frequency, antiseizure medication (ASM) standardized dose and number, age, gender, depression and insomnia symptom severity, and apnea-hypopnea index (HPI) and total sleep time on PSG (coefficients [95% confidence interval (CI)]: -0.26 [-0.48, -0.05], p = 0.018). The area under the curve (AUC) of the ESS ROC predicting MSL < 8 min and MSL < 5 min were similar: 0.62 (95%CI: 0.52-0.72) and 0.62 (95%CI: 0.51-0.74).
Conclusions: This is the largest prospective cross-sectional observational study to date using MSLT in AWE. We found subjective and objective daytime sleepiness highly prevalent in AWE and not explained by seizure frequency, ASM burden, symptoms of insomnia/depression, or PSG findings although those with MSL < 5 min were more likely to have obstructive sleep apnea (OSA). Pathologic sleepiness with MSL < 8 min was present in half of AWE. Nearly one-third of AWE unselected for sleep/wake complaints had MSL < 5 min, a range typical of narcolepsy.
Competing Interests: Declaration of competing interest None.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

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