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Factors determining the long-term compliance with PAP therapy in patients with sleep-related epilepsy
Clinical Neurology and Neurosurgery ( IF 1.9 ) Pub Date : 2021-03-01 , DOI: 10.1016/j.clineuro.2021.106498 Gülçin Benbir Şenel 1 , Derya Karadeniz 1
Clinical Neurology and Neurosurgery ( IF 1.9 ) Pub Date : 2021-03-01 , DOI: 10.1016/j.clineuro.2021.106498 Gülçin Benbir Şenel 1 , Derya Karadeniz 1
Affiliation
INTRODUCTION
In adult patients with epilepsy, treatment of comorbid obstructive sleep apnea syndrome (OSAS) by positive airway pressure (PAP) therapy results in improvements in the control of seizures. This is the first study investigating the long-term compliance with PAP therapy in patients with sleep-related epilepsy and OSAS. METHODS
In this longitudinal study, patients with sleep-related epilepsy and OSAS were followed-up for five years. The compliance with PAP therapy was defined as the use of PAP therapy for at least four hours per night for more than 70 % of nights. RESULTS
A total of 58 patients with sleep-related epilepsy and OSAS completed study protocol. Eleven patients (19.0 %) refused PAP treatment for OSAS, and 13 patients (22.3 %) showed irregular use. Remaining 34 patients (58.7 %) were compliant with PAP therapy. Females were found to be more compliant than males (p = 0.027), while the age was not found to correlate with the compliance (p = 0.721). Epilepsy-related factors including the types of seizures, whether pure sleep-related or mixed (p = 0.403), localization (p = 0.920) or lateralization (p = 0.697) of discharges, showed no effect on the compliance with PAP therapy. On the other hand, patients with a lower number of seizures (p = 0.042) or with a lower seizure frequency (p = 0.048) showed better compliance with PAP therapy. Polysomnographic parameters including severity of OSAS failed to show a significant correlation. CONCLUSION
Our findings showed that about two thirds of the study population was compliant with PAP therapy after a mean follow-up duration of almost three years. Newly-diagnosed patients, mostly females, with a lower number of total seizures and lower seizure frequency seem to be more compliant with PAP therapy, which implies the significance of investigation and treatment of OSAS as early as possible in the patients with sleep-related seizures.
中文翻译:
决定睡眠相关性癫痫患者长期 PAP 治疗依从性的因素
引言 在成年癫痫患者中,通过气道正压通气 (PAP) 疗法治疗合并阻塞性睡眠呼吸暂停综合征 (OSAS) 可改善对癫痫发作的控制。这是第一项调查睡眠相关癫痫和 OSAS 患者对 PAP 治疗的长期依从性的研究。方法 在这项纵向研究中,对睡眠相关性癫痫和 OSAS 患者进行了 5 年的随访。对 PAP 治疗的依从性定义为在超过 70% 的夜晚使用 PAP 治疗每晚至少 4 小时。结果共有 58 名睡眠相关性癫痫和 OSAS 患者完成了研究方案。11 名患者 (19.0 %) 因 OSAS 拒绝 PAP 治疗,13 名患者 (22.3 %) 显示不规则使用。其余 34 名患者 (58.7 %) 依从 PAP 治疗。发现女性比男性更顺从(p = 0.027),而年龄与顺从性无关(p = 0.721)。癫痫相关因素,包括癫痫发作的类型,无论是纯睡眠相关还是混合(p = 0.403)、定位(p = 0.920)或侧化(p = 0.697),对 PAP 治疗的依从性没有影响。另一方面,癫痫发作次数较少(p = 0.042)或癫痫发作频率较低(p = 0.048)的患者对 PAP 治疗的依从性更好。包括 OSAS 严重程度在内的多导睡眠图参数未能显示出显着的相关性。结论 我们的研究结果表明,大约三分之二的研究人群在平均随访近三年后依从 PAP 治疗。新诊断的患者,多为女性,
更新日期:2021-03-01
中文翻译:
决定睡眠相关性癫痫患者长期 PAP 治疗依从性的因素
引言 在成年癫痫患者中,通过气道正压通气 (PAP) 疗法治疗合并阻塞性睡眠呼吸暂停综合征 (OSAS) 可改善对癫痫发作的控制。这是第一项调查睡眠相关癫痫和 OSAS 患者对 PAP 治疗的长期依从性的研究。方法 在这项纵向研究中,对睡眠相关性癫痫和 OSAS 患者进行了 5 年的随访。对 PAP 治疗的依从性定义为在超过 70% 的夜晚使用 PAP 治疗每晚至少 4 小时。结果共有 58 名睡眠相关性癫痫和 OSAS 患者完成了研究方案。11 名患者 (19.0 %) 因 OSAS 拒绝 PAP 治疗,13 名患者 (22.3 %) 显示不规则使用。其余 34 名患者 (58.7 %) 依从 PAP 治疗。发现女性比男性更顺从(p = 0.027),而年龄与顺从性无关(p = 0.721)。癫痫相关因素,包括癫痫发作的类型,无论是纯睡眠相关还是混合(p = 0.403)、定位(p = 0.920)或侧化(p = 0.697),对 PAP 治疗的依从性没有影响。另一方面,癫痫发作次数较少(p = 0.042)或癫痫发作频率较低(p = 0.048)的患者对 PAP 治疗的依从性更好。包括 OSAS 严重程度在内的多导睡眠图参数未能显示出显着的相关性。结论 我们的研究结果表明,大约三分之二的研究人群在平均随访近三年后依从 PAP 治疗。新诊断的患者,多为女性,