摘要 目的：随着睡眠医学的发展，癫癎患者的睡眠质量作为生活质量的一个重要内容已日益受到重视。由于儿童睡眠研究的复杂性，目前关于癫癎儿童睡眠状态的研究较少。该研究旨在初步探讨癫癎对儿童发作间期睡眠的影响。方法：采用多导睡眠生理脑电记录仪对48名癫癎儿童及12名正常健康对照儿童进行全夜多导睡眠脑电记录仪检查，按照癫癎发作类型、发作好发时间将患儿分为全面性癫癎组、局灶性癫癎组以及清醒发作组、睡眠发作组，评价各组患儿与健康对照儿童之间各项睡眠参数的差异。结果：与健康对照儿童比较,癫癎儿童睡眠效率(SE)下降（85.4±8.6）% vs （90.9±5.8）% ，(P<0.05)。局灶性癫癎儿童睡眠总记录时间(TRT)延长、SE下降；全面性癫癎非快速动眼S1期睡眠比例（S1%）增加，快速动眼睡眠比例(REM%)减少；易在睡眠期发作的癫癎S1%延长，REM%、SE较对照组减少，其中全面性癫癎组REM%、SE缩短,局灶性癫癎组TRT、S1%延长，SE下降；易在觉醒期发作的癫癎与对照组各项睡眠参数无统计学差异。结论：癫癎可影响儿童的睡眠结构，不同类型的癫癎对儿童睡眠结构影响不同。全面性癫癎患儿浅睡眠延长、快动眼睡眠缩短，其中易在觉醒期发作的儿童以浅睡眠延长为主，易在睡眠期发作的儿童以快动眼睡眠缩短、睡眠效率降低为主。局灶性癫癎患儿睡眠效率降低，其中易在觉醒期发作的儿童睡眠结构无异常，易在睡眠期发作的儿童以浅睡期延长、睡眠效率降低为主。［中国当代儿科杂志，2007，9（1）：6-10］
Abstract：OBJECTIVE: To evaluate the effect of epilepsy on sleep in children. METHODS: Whole night polysomnography was performed in 48 epileptic children and 12 healthy controls. The 48 epileptic children were divided into focal seizure and generalized seizure groups and into waking seizure and sleeping seizure groups according to the time of occurrence of the seizures. Various parameters of sleep structure were analyzed. RESULTS: The sleep efficiency of epileptic children was significantly lower than that of the healthy controls (85.4 ± 8.6% vs 90.9 ± 5.8%; P<0.05). The total recording time (TRT) of sleep was significantly longer and the sleep efficiency was significantly lower in the focal seizure group compared to the control group (P<0.05). The percentage of stage 1 non-rapid-eye-movement sleep (S1 sleep) increased and the percentage of rapid-eye-movement (REM) sleep decreased in the generalized seizure group compared to the control group (P<0.05). The percentage of S1 sleep increased and both the percentage of REM sleep and the sleep efficiency decreased in the sleeping seizure group as compared with the control group (P<0.05). There were no significant differences in the parameters of sleep structure between the waking seizure and the control group. Among the sleeping seizure group, the children with generalized seizure showed significantly lower REM sleep percentage and sleep efficiency, and those with focal seizure had significantly longer TRT and higher S1 sleep percentage as compared with the controls. CONCLUSIONS: Epilepsy affects sleep structure of patients, and different types of seizure have different influences on sleep structure. Children with generalized seizure have prolonged light sleep and shortened REM sleep. When generalized seizures occur during waking, the increase of light sleep is more pronounced. While generalized seizures occur during sleeping, REM sleep reduction is more prominent. Children with focal seizures have decreased sleep efficiency. When focal seizures occur during waking, the sleep structure of patients is normal. However, when seizures occur during sleeping light sleep increases and sleep efficiency decreases.［Chin J Contemp Pediatr, 2007, 9 (1):6-10］
