李康丽,王兰桂

癫痫与睡眠障碍存在复杂的双向关联，睡眠障碍不仅影响患者生活质量，还可能诱发癫痫发作。本文系统梳理了全面性癫痫、局灶性癫痫、儿童癫痫综合征等不同癫痫类型患者睡眠障碍的临床特征，从发作类型、抗癫痫药物（Anti-epileptic medications，AEDs）、共病状态、神经机制等维度解析影响因素，并探讨睡眠障碍对癫痫控制的反作用。研究表明，不同癫痫类型的睡眠障碍表现具有特异性，如全面性强直-阵挛发作患者以睡眠结构紊乱为主，儿童良性癫痫伴中央颞区棘波（Benign childhood epilepsy with centrotemporal spikes，BECTS）常合并夜间惊厥发作；影响因素涉及神经递质失衡（如GABA、5-羟色胺）、AEDs的镇静/兴奋副作用、心理应激及昼夜节律失调等。未来需聚焦精准化睡眠干预与癫痫-睡眠共病的管理，为临床个体化诊疗提供依据。

癫痫；睡眠障碍；临床特征；影响因素；共病

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