소아 및 청소년기 간질과 만성두통 환자에서의 수면장애
Sleep Problems in Children and Adolescents with Epilepsy and Chronic Headaches
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초록
목적:수면은 여러 신경계 질환과 서로 영향을 주고 받는다. 신경계 질환에 의해 수면장애가 나타날 수 있고, 수면장애가 신경계 질환을 악화시킬 수 있다. 본 연구는 소아청소년기의 대표적인 신경계 질환인 간질과 만성두통 환자의 수면양상에 대해서 알아보고자 하였다. 방법:소아신경클리닉 외래를 방문하는 6-18세의 간질 환자와 만성두통 환자를 대상으로 설문지를 통해 수면양상을 관찰하였다. 운동장애, 염색체이상, 또는 신경근육질환 등을 동반한 환자는 제외하였다. 결과:총 276명(간질 200명, 만성두통 76명)에게 시행되었고, 연령은 11.8±3.3세였다. 만성두통군이 간질군에 비해 평일의 수면시간이 짧았으며, 아침에 일어나기 어렵고, 자야할 시간에 자려고 하지 않고, 다리에 간질간질하거나 벌레가 기어다니는 듯한 이상감각을 느끼고, 낮에 과도하게 졸리고, 쉽게 화가 나고 무기력해지는 등의 수면 관련 증상이 간질군에 비해 만성두통군의 더 많은 환자에서 관찰되었다. 결론:소아청소년기 만성두통과 간질 환자들은 상당수에서 수면문제를 동반하고 있고, 만성두통 환자들에서 보다 빈번하다. 소아청소년기 만성두통과 간질의 진단과 치료에 동반하는 수면장애에 대한 파악과 이에 대한 적절한 대처가 필요하다.
Abstract
Purpose:Sleep is correlated with various neurological disorders. Epilepsy and chronic headaches(CH) are the most common causes of visiting children in neurology clinics. The aim of the present study is to evaluate the sleeping patterns of patients with epilepsy and CH. Methods:Children and adolescents of between the ages 6-18 suffering from epilepsy or CH were assessed using the sleep questionnaires. Patients with motor disabilities, chromosomal abnormalities or neuromuscular diseases were excluded. Results:Sleeping patterns of the 276 patients were analyzed(200 epilepsy and 76 CH). The mean age of the patients was 11.8±3.3 years. CH patients had more excessive daytime sleepiness, shorter total sleep time on weekday, later bedtime, and more trouble getting up in the morning than epilepsy patients(P<0.001). CH patients also had more mood instabilities, resistance to going to bed on time, and uncomfortable feelings in legs than epilepsy patients(P<0.05). On the contrary, epilepsy patients had more bed-wettings than CH patients(P<0.05). Conclusion:It is suggested that CH is more associated with sleep problems than epilepsy. The consideration and proper treatment for accompanying sleep problems are needed when we treat chronic headaches or epilepsy.
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