Investigation of sleep microstructure in generalized and partial epilepsy syndromes

The research was carried out in order to show the differences between the macro and microstructures of sleep in generalized and partial epilepsy patients and healthy control groups. The study was conducted as analytical case control, with a total of 89 patients, among generalized and partial epilepsy patients and healthy control groups, who came to Aydın Adnan Menderes Application and Research Hospital Neurology Outpatient Clinic between September 2021 and September 2022. One-night PSG-EEG and Pittsburgh Sleep Quality Index test were performed on the patients. The sleep macro and especially the microstructures of the research group were examined. SPSS version 26.0 program was used in the analysis of the data and Student-t, Mann Whitney U, ANOVA, Kruskal Wallis, Pearson chi-square, Fisher's exact tests were applied. The statistical significance level was accepted as p<0.05. OSAS was detected in 6.4% of the study group as a result of PSG-EEG. 83.3% of the patients were diagnosed with partial epilepsy and 17.7% with generalized epilepsy. Central imaging of patients with generalized epilepsy is normal, MTLS was detected in 42.8% of patients with partial epilepsy. Significant differences were found in the REM latency, NREM stage 2 percentage, and sleep spindle structure of those with MLTS. IED (only generalized epilepsy) was detected in 18.6% of patients who underwent PSG-EEG. A significant difference was found only in the arousal sleep index of the patients with IED. As a result of the PSQİ test, the score was ≥5 in 54.8% of generalized epilepsy and 75% of partial epilepsy. Significant differences were found in the sleep macrostructure of the research group in terms of REM duration, REM percentage, REM latency, sleep efficiency and NREM stage 2 percentage. In the microstructure evaluation of sleep, significant differences were found in sleep spindle and K-complex parameters, arousal, position change and desaturation index. As a result of the comparison of antiepileptic drugs in epilepsy patients, significant differences were found in those using valproic acid (position change index), levetiracetam (REM latency and sleep spindle index), lamotrigine (sleep spindle frequency) and carbamazepine (sleep spindle number, index, frequency, duration, NREM stage 2 spindle number and duration, arousal and stage change index). In our thesis study, statistically significant differences were found between epilepsy and healthy control groups in terms of macro and especially micro structures of sleep. Keywords: Sleep microstructure, Sleep spindle, K-complex, Sleep and Epilepsy