Epilepsili Hastalarda Uyku Bozuklukları ve Bunun Yaşam Kalitesine Etkisi

Amaç: Epilepsili hastalarda yaşam ve uyku kalitesi pek çok faktörden etkilenmektedir. Bu hasta grubunda yaşam kalitesinde etkili faktörlerin tespit edilip düzeltilmesi, hastalığın sonuçlarını olumluya çevirmede yararlıdır. Bu çalışmada epilepsili hastalarda uyku bozuklukları ve bu bozuklukların yaşam kalitesi üzerine etkisi araştırıldı. Materyal ve Metot: Çalışmaya 43 epilepsi hastası ve 29 sağlıklı gönüllü dahil edildi. Çalışmaya katılan tüm bireylere nöroloji uzmanı denetiminde Beck Depresyon Ölçeği (BDÖ) ve Pittsburgh Uyku Bozuklukları İndeksi (PUKİ), Hamilton Anksiyete Ölçeği (HAÖ), Berlin Uyku Anketi (BUA), Epworth Uykululuk Ölçeği (EUÖ), Stanford Uykululuk Ölçeği (SUÖ) uygulanırken, epilepsili hastalara ek olarak Epilepside Yaşam Kalitesi31 Ölçeği (EYKÖ-31) de uygulandı. Epilepsili hastalarda ölçeklerden alınan puanlar, sağlıklı kontrollerin ölçeklerden aldıkları puanlarla ve epilepsili hastalarda EYKÖ-31 puanları diğer ölçeklerden alınan puanlarla kıyaslandı. Bulgular: Epilepsili hastalarda EUÖ, BUA ve HAÖ’den alınan puanlar, sağlıklı kontrollerin puanlarına göre anlamlı olarak daha yüksek bulundu. Epilepsili hastalarda EYKÖ-31 puanları ile SUÖ, PUKİ, BDÖ ve EUÖ puanları arasında doğrusal, orta güçlükte ve negatif yönlü, istatistiksel olarak anlamlı bir ilişki bulunmuştur. Sonuç: Epilepside aşırı gün içi uykululuk, uykuda apne riski ve anksiyete bozukluğu sıktır. Epilepsili hastalarda kötü uyku kalitesi, aşırı gün içi uykululuk ve depresyon yaşam kalitesini olumsuz etkiler. Bu hasta grubunda uyku bozukluklarının erken teşhis ve tedavisi yaşam kalitesini olumluya çevirmede etkilidir.

Anahtar Kelimeler:

Epilepsi, Uyku bozuklukları, yaşam kalitesi

Sleep Disturbances in Patient with Epilepsy and its Effect on the Quality of Life

Aim: Quality of life andsleepareinfluencedbymanyfactors in patientswithepilepsy. It is benefical to identify and resolve the factors that affect the quality of life for converting the results of the disease into positive. We investigated sleep disorders and the effect of these disorders on the quality of life in patient with epilepsy. Material and Method: 43 patient with epilepsy and 29 healthy volunteers were included in the study. The Beck Depression Scale (BDS), the Pittsburgh Sleep Quality Index (PSQI), the Hamilton Anxiety Scale (HAS), the Berlin Sleep Questionnaire (BSQ), the Epworth Sleepiness Scale (ESS) and Stanford Sleepiness Scale (SSS) were administered to all the participants in the study under the supervision of neurology specialist, Quality of life in Epilepsy (QOLIE-31) was also applied in patient with epilepsy. Scores from scales in patient with epilepsy were compared to scores from healthy volunteers’s scores and scores of scales that obtained patient with epilepsy compared to scores of QOLIE-31 form. Results: The scores of the ESS, BSQ and HAS in patient with epilepsy were significantly higher than the scores of the healthy controls. There was a linear, moderate, negative and statistically significant relationship between QOLIE-31 scores and SSS, PSQI, BDS and ESS scores in patient with epilepsy. Conclusion: Excessive daytime sleepiness, sleep apnea and anxiety disorder is common in epilepsy. Poor sleep quality, excessive daytime sleepiness and depression negatively affect quality of life in patient with epilepsy. Early diagnosis and treatment of sleep disorders in this group of patients is influential in converting the quality of life into positive.

Keywords:

Epilepsy, sleepdisturbance, quality of life,

PDF

___

1-Stables JP, Bertram EH, White HS, et al. Models for epilepsy and epileptogenesis: report from the NIH workshop, Bethesda, Maryland. Epilepsia2002; 43:1410-20.
2-Sammaritano M, Gigli GL, Gotman J. Interictalspiking during wakefulness and sleep and the localization of foci in temporallobeepilepsy. Neurol 1991; 41(2):290-7.
3-Malow BA, Lin X, Kushwaha R, et al. Interictal spiking increases with sleep depth in temporal lobe epilepsy. Epilepsia.1998; 39(12):1309-16.
4-Minecan D, Natarajan A, Marzec M, et al. Relationship of epileptic seizures to sleep stage and sleep depth.Sleep 2002; 25(8):899-904.
5-Crespel A, Coubes P, Baldy-Moulinier M. Sleep influence on seizures and epilepsy effects on sleep in partial frontal and temporal lobe epilepsies. Clin Neurophysiol. 2000; 111(2):54-9.
6- Göksan B. Uyku ve epilepsi. Türkiye Klin Dahili Tıp Bil Nörol 2007; 3(26): 40–3.
7- Fidaner H, Billington R, Eser E, et al. Yaşam kalitesi ve ruh sağlığı. 34. Ulusal Psikiyatri kongresi Bilimsel Çalışmalar Özet Kitabı 1998; 53-6.
8-Manocchia M, Keller S, Ware JE. Sleep problems, health-related quality of life, work function in gand healthcare utilization among the chronically ill. Qual Life Res.2001; 10(4): 331-45.
9-Harden CL. Theco-morbidity of depression and epilepsy: epidemiology, etiology, andtreatment. Neurol 2002; 24(59):48-55.
10-Öner P, Barut Y, Öner Ö, et al. Çocuklarda uyku ölçeğinin geçerlik ve güvenirliği. Klin Psikofarmakol Bül 2009; 19:382–95.
11-Vaughn, BV, D'Cruz OF. Sleepandepilepsy. Semin Neurol. 2004; 24 (3):301-13.
12-Devinsky O, Ehrenberg B, Barthlen GM, et al. Epilepsy and sleep apne asyndrome. Neurol 1994; 44 (11):2060-4.
13- Ağargun MY, Kara H, Anlar O. Pittsburgh uyku kalitesi indeksinin gecerliliği ve guvenirliği. Tr Psikiyatri Derg 1996; 7(2):107-15.
14- Netzer NC, Stoohs RA, Netzer CM, et al. Using the Berlin Questionnaireto identify patients at risk forthe sleep apnea syndrome. Ann Intern Med 1999; 131(7):485-91.
15- Abrishami A, Khajehdehi A, Chung F. A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anaesth 2010; 57(5):423-38.
16-Hoddes E, Zarcone V, Smythe H, et al. Quantification of sleepiness: a newapproach. Psychophysiol 1973; 10(4):431-6. 17-MacLean AW, Fekken GC, Saskin P, et al. Psychometric evaluation of the Stanford Sleepiness Scale. J Sleep Res 1992; 1(1):35-9.
18-Izci B, Ardic S, Firat H, et al. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath 2008; 12(2):161-8.
19-Johns MW. A new method for measuring day time sleepiness: the Epworth sleepiness scale. Sleep 1991; 14 (6):540-5.
20-Weerd AD, Hass SD, Otte A, et al. Subjective sleep disturbance in patients with partialepilepsy; a qestionnaire based study on prevalance and impact on qality of life. Epilepsia 2004; 45(11):1397–1404.
21-Piperidou C, Karlovasitou A, Triantafyllou N, et al. Influence of sleep disturbance on quality of life of patients with epilepsy. Seizure 2008; 17:588–94.
22-Chen NC, Tsai MH, Chang CC, et al. Sleep quality and day time sleepiness in patients with epilepsy. Acta Neurol Taiwan 2011; 20:249–56.
23- lobucnikova K, Kollar B. Day time sleepiness andchanges of sleep in patients with epilepsy. Ġn: Sibat HF (ed). Novelaspects on epilepsy. InTech; 2011; Ch 3, 29–52.
24- Krishnan P, Sinha S, Taly AB, et al. Sleep disturbances in juvenile myoclonic epilepsy: a sleep questionnaire-basedstudy. Epilepsy Behav 2012; 23(3):305–9.
25-Mattson RH. Selection of antiepileptic drug therapy. In: Levy R, Mattson RH, Meldrum B, Penry JK, editors. Anticepticdrugs, 3rd ed. 1989. pp. 103-5.
26- Zucconi M, Oldani A, Smirne S, et al. The macrostructure and microstructure of sleep in patients with autosomal dominant nocturnal frontall obeepilepsy. J ClinNeurophysiol 2000; 17(1):77-8.
27-Wyler AR, Weymuller EA. Epilepsycom plicatedbysleep-apnea. AnnNeurol 1981; 9:403-4.
28-Manni R, Tartara A. Evaluation of sleepiness in epilepsy. Clin Neurophysiol 2000; 111:111-4.
29-Davinsky O, Eherenberg B, Barthlen GM, et al. Epilepsy and sleep-apnea syndrome. Neurol 1994; 44:2060-9.
30-Khatami R, Zutter D, Siegel A, et al. Sleepwake habits and disorders in a series of 100 adult epilepsy patients– a prospective study. Seizure 2006; 15:299–306.
31-Chan B, Cheong EYY, GraceNg SF, et al. Evaluation of sleep disturbances in childrenwith epilepsy: a questionnaire-basedcase–control study. Epilepsy Behavior 2011; 21:437–40.
32-Kwan P, Yu E, Leung H, et al. Association of subjective anxiety, depression, and sleep disturbance with quality-of-liferatings in adults with epilepsy. Epilepsia. 2009; 50(5):1059-66.
33-Jones JE, Hermann BP, Barry JJ, et al. Clinical assessment of axis I psychiatric morbidity in chronic epilepsy: a multicenter investigation. J Neuropsychiatry ClinNeurosci 2005; 17:172–9.
34-O’Donoghue MF, Goodridge DMG, Redhead K, et al. Assessing the psychosocial consequences of epilepsy: a community-based study. Br J Gen Pract 1999; 49:211–4.
35-Manni R, Politine L, Ratti MT, et al. Sleepiness and its associated factors in epilepsy patients. Sleep 1998; 21:175. [Abstract]
36-Wiegartz P, Seidenberg M, Woodard A, et al. Co-morbid psychiatric disorder in chronic epilepsy: recognitoin and etiology of depression. Neurol 1999; 53:3-8.
37- Gilliam F. Optimazinghealthoutcomes in activeepilepsy. Neurol 2002; 58:9-20.