Veränderungen der Schlafarchitektur bei Epilepsiepatienten - Eine klinische Studie

Epilepsie ist mit über 70 Millionen Betroffenen eine der häufigsten chronischneurologischen Erkrankungen weltweit. Eine der häufigsten Komorbiditäten der Epilepsie sind Schlafstörungen. Studien, die sowohl subjektive als auch objektive Schlafparameter untersuchten, zeigten bei den Epilepsiepatien...

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Bibliographic Details
Main Author: Elsner, Skadi Marleen Anni
Contributors: Menzler, Katja (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2024
Online Access:PDF Full Text
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With more than 70 million patients, epilepsy is one of the most common chronic neurological diseases worldwide. One of the most common comorbidities of epilepsy are sleep disturbances. Studies that examined both subjective and objective sleep parameters showed changes in sleep in epilepsy patients. Sleep parameters such as sleep efficiency or the different sleep phases were altered in earlier studies. So far, there have only been a few small studies on this topic. They compared epilepsy patients with healthy controls. The aim of the present study was to compare the sleep architecture of epilepsy patients with control patients suffering from dissociative nonepileptic seizures. The resulting hypotheses for this study were: 1. The proportions of the individual sleep stages differ significantly in epilepsy and control patients, and 2. Epilepsy patients show a poorer sleep efficiency than the patients in the control group. The study included 54 patients and a total of 79 PSGs. The sleep of 42 patients with epileptic seizures and 12 patients with dissociative seizures was analysed using video EEG monitoring and polysomnography. The five main parameters sleep efficiency, proportion of sleep stage 1 (N1), proportion of sleep stage 2 (N2), proportion of sleep stage 3 (N3) and proportion of sleep stage REM were examined using the Welch test. The analysis of the side-parameters time in bed (TIB), total sleep time (TST), sleep onset latency, REM latency, wake time after sleep onset, arousal index and respiratory disturbance index (RDI) was carried out exploratively. In the epilepsy patients, there was a significant difference in the proportion of sleep stages 2, 3, REM, in the TIB and the arousal index. The sleep stage 2 was significantly lower in the epilepsy group than in the controls (p = 0.014), as were the TIB (p = 0.027) and arousal index (p = 0.049). The proportion of sleep stage 3 was significantly higher in the epilepsy patients than in the control subjects (p = 0.022), as well as the proportion of REM stage (p = 0.013). There were non-significant differences for the other main and side-parameters. The findings from previous studies were partially confirmed in the present study. A pronounced heterogeneity of the sleep changes in epilepsy patients can be observed in the different studies. However, all studies come to the conclusion that sleep architecture is altered in patients with epilepsy. A next starting point for further studies could be a comparison of the sleep architecture of epilepsy patients with healthy controls and patients with dissociative seizures. This could answer the question whether the epileptic activity or the seizures themselves have a greater impact on patients' sleep.