Subjective and objective hypersomnia highly prevalent in adults with epilepsy
| Autor: | James Bena, Madeleine Grigg-Damberger, Nancy Foldvary-Schaefer, Noah Andrews, Lu Wang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Multiple Sleep Latency Test
Adult Male medicine.medical_specialty Sleepiness Polysomnography Excessive daytime sleepiness Disorders of Excessive Somnolence 03 medical and health sciences Behavioral Neuroscience Epilepsy Diagnostic Self Evaluation 0302 clinical medicine Insomnia Prevalence Medicine Humans 030212 general & internal medicine Prospective Studies Wakefulness Prospective cohort study medicine.diagnostic_test business.industry Epworth Sleepiness Scale Middle Aged medicine.disease Confidence interval Cross-Sectional Studies Neurology Physical therapy Female Neurology (clinical) medicine.symptom business Sleep 030217 neurology & neurosurgery |
| Zdroj: | Epilepsybehavior : EB. 106 |
| ISSN: | 1525-5069 |
| Popis: | 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).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 and5 min and investigate the optimal cutpoints.Among 127 AWE (mean age: 38.7 ± 13.7 years), abnormal MSL (8 min) was observed in 49.6% and MSL5 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).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. |
| Databáze: | OpenAIRE |
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