Association of baseline sleep duration and sleep quality with seizure recurrence in newly treated patients with epilepsy

IF 6.6 1区医学 Q1 CLINICAL NEUROLOGY

Epilepsia Pub Date : 2024-09-11 DOI:10.1111/epi.18106

Rui Zhong, Guangjian Li, Teng Zhao, Hanyu Zhang, Xinyue Zhang, Weihong Lin

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引用次数: 0

Abstract

Objective

Although sleep duration and sleep quality are considered to be significant factors associated with epilepsy and seizure risk, findings are inconsistent, and their joint association remains uncertain. This study aimed to determine independent and joint associations of these two modifiable sleep features with seizure recurrence risk in newly treated patients with epilepsy (PWE).

Methods

This is a prospective cohort study of newly treated PWE at a comprehensive epilepsy center in northeast China between June 2020 and December 2023. Self-reported sleep duration and sleep quality were collected at baseline. All patients were followed for 12 months for recurrent seizures. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) of seizure recurrence. Models fitted with restricted cubic spline were conducted to test for linear and nonlinear shapes of each association.

Results

A total of 209 patients were included, and 103 experienced seizure recurrence during follow-up. Baseline short sleep was significantly associated with greater risk of seizure recurrence (adjusted HR = 2.282, 95% confidence interval [CI] = 1.436–3.628, p < .001). Sleep duration (h/day) and recurrent seizure risk showed a significant nonlinear U-shaped association, with a nadir at 8 h/day. Baseline poor sleep quality was significantly associated with greater risk of seizure recurrence (adjusted HR = 1.985, 95% CI = 1.321–2.984, p < .001). Pittsburgh Sleep Quality Index score and seizure recurrence risk exhibited a positive linear association. Participants with a combination of poor quality–short sleep showed the highest risk of seizure recurrence (adjusted HR = 3.13, 95% CI = 1.779–5.507, p < .001) compared to the referent good quality–intermediate sleep group.

Significance

Baseline sleep duration and sleep quality were independently and jointly associated with risk of seizure recurrence in newly treated PWE. Our results point to an important potential role of baseline sleep duration and sleep quality in shaping seizure risk.

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新近接受治疗的癫痫患者的基线睡眠时间和睡眠质量与癫痫复发的关系

目的虽然睡眠时间和睡眠质量被认为是与癫痫和癫痫发作风险相关的重要因素，但研究结果并不一致，而且它们之间的联合关系仍不确定。本研究旨在确定这两种可改变的睡眠特征与新近接受治疗的癫痫患者（PWE）癫痫复发风险的独立和联合关系。方法这是一项前瞻性队列研究，研究对象为2020年6月至2023年12月期间在中国东北地区一家综合性癫痫中心接受治疗的新近接受治疗的癫痫患者。基线研究收集了患者自我报告的睡眠时间和睡眠质量。对所有患者进行为期 12 个月的复发性癫痫发作随访。Cox比例危险回归模型用于估计癫痫复发的危险比（HRs）。结果共纳入 209 名患者，其中 103 名患者在随访期间癫痫复发。基线睡眠时间较短与癫痫复发风险较高明显相关（调整后 HR = 2.282，95% 置信区间 [CI] = 1.436-3.628，p <.001）。睡眠持续时间（小时/天）与癫痫复发风险呈显著的非线性 U 型关系，最低点为 8 小时/天。基线睡眠质量差与更高的癫痫复发风险显著相关（调整后 HR = 1.985，95% CI = 1.321-2.984，p < .001）。匹兹堡睡眠质量指数得分与癫痫复发风险呈正线性关系。与参考的良好睡眠质量-中等睡眠组相比，睡眠质量差-睡眠时间短组合的参与者癫痫复发风险最高（调整后 HR = 3.13，95% CI = 1.779-5.507，p <.001）。我们的研究结果表明，基线睡眠时间和睡眠质量在影响癫痫发作风险方面具有重要的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsia 医学-临床神经学

CiteScore

10.90

自引率

10.70%

发文量

319

审稿时长

2-4 weeks

期刊介绍： Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.