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Kang HJ, Torres K, Kim MS. Differences in health-related quality of life and somatic symptoms in employed and unemployed patients with epilepsy. Epilepsy Behav Rep 2024; 26:100663. [PMID: 38708365 PMCID: PMC11067481 DOI: 10.1016/j.ebr.2024.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/18/2024] [Accepted: 03/29/2024] [Indexed: 05/07/2024] Open
Abstract
This study compared overall and specific aspects of health-related quality of life (HRQOL) and self-report of somatic, anxiety, and depressive symptoms between employed (n = 71) and unemployed (n = 48) patients with epilepsy (PWE). The Quality of Life in Epilepsy (QOLIE-89) and the Personality Assessment Inventory (PAI) were examined. The unemployed group reported significantly worse overall HRQOL including aspects of HRQOL related to epilepsy, physical health, mental health, and cognitive function. Among these four, physical health related HRQOL revealed the most difference between groups. While there were no differences between the groups in the level of social support and social isolation, the unemployed group reported worse social function with respect to work and driving. The unemployed group reported significantly greater somatic symptoms, but not anxiety and depressive symptoms. When specifically examining the subscales of the Somatic Concerns scale, conversion and health concerns, but not somatization, were greater in the unemployed group. Among the Depression subscales, the unemployed group reported greater physiologically manifested depressive symptoms. These findings suggest that along with optimizing seizure control, identifying and addressing presence of physical limitations, dysfunction, and somatic symptoms are also of importance in the care of PWE, particularly for those who are unemployed.
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Affiliation(s)
- Hyun Jin Kang
- Department of Neurology, University of Washington, United States
| | - Karen Torres
- Department of Neurology, University of Washington, United States
| | - Michelle S. Kim
- Department of Neurology, University of Washington, United States
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2
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Xiao Y, Zhou J, Xiong W, Lu L, Zhou D. Gender differences in prevalence and risk factors of sleep disturbances in patients with epilepsy. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-021-00070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Sleep disturbances are frequently observed in patients with epilepsy (PWE), with adversely effects on life quality and seizure control. The study aimed to assess the gender differences in incidence and factors of sleep disturbances in PWE.
Methods
PWE confirmed the diagnosis of epilepsy were consecutively enrolled in this cross-sectional study, with detailed information recorded. A group of healthy participants were recruited as the control. Sleep and mood disorders were evaluated with the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).
Results
One hundred and thirty-three patients (age: 30.2 ± 10.6 years, men: 51%) and 150 healthy subjects were recruited in this study. Compared with healthy controls, PWE had higher mean scores of the ISI and BDI (p < 0.001 and p = 0.01). There were no significant gender differences in the prevalence and scores of sleep disturbances in PWE. In the overall PWE, nocturnal seizures and focal epilepsy were respectively related to insomnia and poor sleep quality (OR = 3.35, p = 0.024; OR = 3.08, p = 0.013), and mood disorders were also important factors in sleep disturbances (p < 0.05). In the analysis by gender, depression, anxiety, nocturnal seizures and focal epilepsy were associated with insomnia and poor sleep quality in men. For women, however, depression mood was the only factor of sleep disturbances.
Conclusions
Though no gender difference was observed in the incidence of sleep disturbances, factors contributing to insomnia and sleep quality were different by gender. The factors and gender differences of sleep disturbances should be taken into account in the clinical treatment.
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3
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Bonilla-Jaime H, Zeleke H, Rojas A, Espinosa-Garcia C. Sleep Disruption Worsens Seizures: Neuroinflammation as a Potential Mechanistic Link. Int J Mol Sci 2021; 22:12531. [PMID: 34830412 PMCID: PMC8617844 DOI: 10.3390/ijms222212531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep disturbances, such as insomnia, obstructive sleep apnea, and daytime sleepiness, are common in people diagnosed with epilepsy. These disturbances can be attributed to nocturnal seizures, psychosocial factors, and/or the use of anti-epileptic drugs with sleep-modifying side effects. Epilepsy patients with poor sleep quality have intensified seizure frequency and disease progression compared to their well-rested counterparts. A better understanding of the complex relationship between sleep and epilepsy is needed, since approximately 20% of seizures and more than 90% of sudden unexpected deaths in epilepsy occur during sleep. Emerging studies suggest that neuroinflammation, (e.g., the CNS immune response characterized by the change in expression of inflammatory mediators and glial activation) may be a potential link between sleep deprivation and seizures. Here, we review the mechanisms by which sleep deprivation induces neuroinflammation and propose that neuroinflammation synergizes with seizure activity to worsen neurodegeneration in the epileptic brain. Additionally, we highlight the relevance of sleep interventions, often overlooked by physicians, to manage seizures, prevent epilepsy-related mortality, and improve quality of life.
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Affiliation(s)
- Herlinda Bonilla-Jaime
- Departamento de Biología de la Reproducción, Área de Biología Conductual y Reproductiva, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de Mexico CP 09340, Mexico;
| | - Helena Zeleke
- Neuroscience and Behavioral Biology Program, College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Asheebo Rojas
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Claudia Espinosa-Garcia
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
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4
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Balzekas I, Sladky V, Nejedly P, Brinkmann BH, Crepeau D, Mivalt F, Gregg NM, Pal Attia T, Marks VS, Wheeler L, Riccelli TE, Staab JP, Lundstrom BN, Miller KJ, Van Gompel J, Kremen V, Croarkin PE, Worrell GA. Invasive Electrophysiology for Circuit Discovery and Study of Comorbid Psychiatric Disorders in Patients With Epilepsy: Challenges, Opportunities, and Novel Technologies. Front Hum Neurosci 2021; 15:702605. [PMID: 34381344 PMCID: PMC8349989 DOI: 10.3389/fnhum.2021.702605] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/29/2021] [Indexed: 01/10/2023] Open
Abstract
Intracranial electroencephalographic (iEEG) recordings from patients with epilepsy provide distinct opportunities and novel data for the study of co-occurring psychiatric disorders. Comorbid psychiatric disorders are very common in drug-resistant epilepsy and their added complexity warrants careful consideration. In this review, we first discuss psychiatric comorbidities and symptoms in patients with epilepsy. We describe how epilepsy can potentially impact patient presentation and how these factors can be addressed in the experimental designs of studies focused on the electrophysiologic correlates of mood. Second, we review emerging technologies to integrate long-term iEEG recording with dense behavioral tracking in naturalistic environments. Third, we explore questions on how best to address the intersection between epilepsy and psychiatric comorbidities. Advances in ambulatory iEEG and long-term behavioral monitoring technologies will be instrumental in studying the intersection of seizures, epilepsy, psychiatric comorbidities, and their underlying circuitry.
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Affiliation(s)
- Irena Balzekas
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
- Mayo Clinic Medical Scientist Training Program, Rochester, MN, United States
| | - Vladimir Sladky
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czechia
| | - Petr Nejedly
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- The Czech Academy of Sciences, Institute of Scientific Instruments, Brno, Czechia
| | - Benjamin H. Brinkmann
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Daniel Crepeau
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Filip Mivalt
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Faculty of Electrical Engineering and Communication, Department of Biomedical Engineering, Brno University of Technology, Brno, Czechia
| | - Nicholas M. Gregg
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Tal Pal Attia
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Victoria S. Marks
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
| | - Lydia Wheeler
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Tori E. Riccelli
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Jeffrey P. Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Brian Nils Lundstrom
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Kai J. Miller
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Jamie Van Gompel
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Vaclav Kremen
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Prague, Czechia
| | - Paul E. Croarkin
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Gregory A. Worrell
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
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Rumble DD, O'Neal K, Overstreet DS, Penn TM, Jackson P, Aroke EN, Sims AM, King AL, Hasan FN, Quinn TL, Long DL, Sorge RE, Goodin BR. Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals. J Behav Med 2021; 44:811-821. [PMID: 34106368 DOI: 10.1007/s10865-021-00234-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 06/03/2021] [Indexed: 02/08/2023]
Abstract
Individuals with chronic low back pain (cLBP) frequently report sleep disturbances. Living in a neighborhood characterized by low-socioeconomic status (SES) is associated with a variety of negative health outcomes, including poor sleep. Whether low-neighborhood SES exacerbates sleep disturbances of people with cLBP, relative to pain-free individuals, has not previously been observed. This study compared associations between neighborhood-level SES, pain-status (cLBP vs. pain-free), and daily sleep metrics in 117 adults (cLBP = 82, pain-free = 35). Neighborhood-level SES was gathered from Neighborhood Atlas, which provides a composite measurement of overall neighborhood deprivation (e.g. area deprivation index). Individuals completed home sleep monitoring for 7-consecutive days/nights. Neighborhood SES and pain-status were tested as predictors of actigraphic sleep variables (e.g., sleep efficiency). Analyses revealed neighborhood-level SES and neighborhood-level SES*pain-status interaction significantly impacted objective sleep quality. These findings provide initial support for the negative impact of low neighborhood-level SES and chronic pain on sleep quality.
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Affiliation(s)
- Deanna D Rumble
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA.
| | | | - Demario S Overstreet
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Terence M Penn
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Pamela Jackson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edwin N Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew M Sims
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Annabel L King
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Fariha N Hasan
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Tammie L Quinn
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - D Leann Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert E Sorge
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
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6
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Sleep quality and daytime sleepiness in epilepsy: Systematic review and meta-analysis of 25 studies including 8,196 individuals. Sleep Med Rev 2021; 57:101466. [PMID: 33838598 DOI: 10.1016/j.smrv.2021.101466] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/26/2022]
Abstract
We sought to gain a better understanding of the relationship between epilepsy and sleep quality and daytime sleepiness by performing a literature search of PubMed for case-control studies that compared patients with epilepsy to controls and reported the Pittsburgh sleep quality index (PSQI) and/or the Epworth sleepiness scale (ESS). Study-specific mean differences in the PSQI and ESS between cases and controls were extracted from the publications and pooled using random-effects meta-analysis. Twenty-five studies (2964 cases, 5232 controls) were included. Fifteen studies reported the PSQI and 24 the ESS. Mean age was 40 years; 50.4% were women. When comparing cases to controls, the pooled mean differences in the PSQI and ESS were 1.27 (95% confidence interval (CI): 0.76, 1.78; P < 0.001; I2: 81.4%) and 0.38 (95% CI: -0.07, 0.84; P = 0.099; I2: 81.0%). Subgroup analyses revealed that mean differences in the ESS were significantly lower in studies with a higher proportion of patients with focal epilepsy (P = 0.004). In this large-scale meta-analysis patients with epilepsy had a higher PSQI, close to the pathological cut-off, compared to controls, but a similar and unremarkable ESS. Further studies are needed to investigate potential effect modifiers, such as specific antiepileptic drugs or seizure frequency.
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7
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KARAPINAR E, YUNUSOĞLU C, TEKIN B, DEDE HÖ, BEBEK N, BAYKAN B, GÜRSES C. Depression is a major determinant of sleep abnormalities in patients with epilepsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:772-777. [DOI: 10.1590/0004-282x20200064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/27/2020] [Indexed: 02/05/2023]
Abstract
ABSTRACT Introduction: We aimed to identify sleep disorders in patients with epilepsy and compare this group with a healthy population. We also analyzed the features of sleep disorders in patients with epilepsy to demonstrate the effect of seizures and seizure types on sleep. Methods: Our study assessed 43 patients with epilepsy and 53 age- and gender-matched healthy controls. The demographic and clinical data of all participants were recorded. The Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), International Restless Legs Syndrome Study Group Rating Scale, Berlin Questionnaire, and Beck Depression Inventory (BDI) were administered to all study subjects. The interview used to evaluate insomnia is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition - DSM-5 diagnostic criteria. Results: Twenty-four patients (55.8%) and 26 controls (49.1%) are women. The mean age of patients and controls was 34.2±11.37 (16-71) and 34.6±11.28 (16-77), respectively. Patients with epilepsy had depression more often than controls, a result that was statistically significant (p<0.0001). We found no statistically significant difference between sleep parameters of patients and controls with normal BDI scores (p>0.05). Patients with depression had worse results on the Berlin Questionnaire and PSQI total score, with statistical significance (p=0.002). Nocturnal seizures, seizure type, and drug treatment had no effect on sleep (p>0.05). Conclusion: We concluded that depression rather than epilepsy negatively affects sleep, suggesting that all patients should be asked about their mood and sleep complaints.
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Affiliation(s)
| | | | - Betül TEKIN
- University of Health Sciences Prof. Dr. Mazhar Osman Bakırköy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Turkey
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8
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Excessive daytime sleepiness and fatigue in neurological disorders. Sleep Breath 2019; 24:413-424. [DOI: 10.1007/s11325-019-01921-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 12/12/2022]
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9
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Vascouto HD, Thais MERDO, Osório CM, Ben J, Claudino LS, Hoeller AA, Markowitsch HJ, Wolf P, Lin K, Walz R. Is self-report sleepiness associated with cognitive performance in temporal lobe epilepsy? ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:575-581. [PMID: 30365619 DOI: 10.1590/0004-282x20180089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/15/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Sleepiness and cognitive impairment are common symptoms observed in patients with epilepsy. We investigate whether self-reported sleepiness is associated with cognitive performance in patients with refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). Seventy-one consecutive patients with MTLE-HS were evaluated with the Stanford Sleepiness Scale (SSS) before neuropsychological evaluation. Their mean SSS scores were compared with controls. Each cognitive test was compared between patients with (SSS ≥ 3) or without sleepiness (SSS < 3). Imbalances were controlled by regression analysis. Patients reported a significantly higher degree of sleepiness than controls (p < 0.0001). After multiple linear regression analysis, only one test (RAVLT total) remained associated with self-reported sleepiness. CONCLUSION Self-reported sleepiness was significantly higher in MTLE-HS patients than controls, but did not affect their cognitive performance. If confirmed in other populations, our results may have implications for decision making about sleepiness screening in neuropsychological settings.
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Affiliation(s)
- Helena Dresch Vascouto
- Universidade Federal de Santa Catarina, Hospital Universitário, Centro de Neurociências Aplicadas, Florianópolis SC, Brasil
| | | | - Camila Moreira Osório
- Universidade Federal de Santa Catarina, Hospital Universitário, Centro de Neurociências Aplicadas, Florianópolis SC, Brasil
| | - Juliana Ben
- Universidade Federal de Santa Catarina, Hospital Universitário, Centro de Neurociências Aplicadas, Florianópolis SC, Brasil
| | - Lucia Sukys Claudino
- Universidade Federal de Santa Catarina, Hospital Universitário, Centro de Neurociências Aplicadas, Florianópolis SC, Brasil.,Universidade Federal de Santa Catarina, Hospital Universitário, Departamento de Clínica Médica, Serviço de Neurologia, Florianópolis SC, Brasil
| | - Alexandre Ademar Hoeller
- Universidade Federal de Santa Catarina, Hospital Universitário, Centro de Neurociências Aplicadas, Florianópolis SC, Brasil
| | | | - Peter Wolf
- Universidade Federal de Santa Catarina, Hospital Universitário, Departamento de Clínica Médica, Serviço de Neurologia, Florianópolis SC, Brasil.,Universidade Federal de Santa Catarina, Departamento de Clínica Médica, Florianópolis SC, Brasil.,Danish Epilepsy Center, Dianalund, Denmark
| | - Katia Lin
- Universidade Federal de Santa Catarina, Hospital Universitário, Departamento de Clínica Médica, Serviço de Neurologia, Florianópolis SC, Brasil.,Universidade Federal de Santa Catarina, Departamento de Clínica Médica, Florianópolis SC, Brasil
| | - Roger Walz
- Universidade Federal de Santa Catarina, Hospital Universitário, Departamento de Clínica Médica, Serviço de Neurologia, Florianópolis SC, Brasil.,Universidade Federal de Santa Catarina, Departamento de Clínica Médica, Florianópolis SC, Brasil
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10
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Grayson LP, DeWolfe JL. Sleep Disorders in Epilepsy: Current Trends and Future Perspectives. CURRENT SLEEP MEDICINE REPORTS 2018. [DOI: 10.1007/s40675-018-0110-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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11
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Shen Y, Zhang M, Wang Y, Wang L, Xu X, Xiao G, Chen J, Zhang T, Zhou N. Subjective sleep disturbance in Chinese adults with epilepsy: Associations with affective symptoms. Epilepsy Res 2017; 135:150-157. [PMID: 28697489 DOI: 10.1016/j.eplepsyres.2017.06.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 06/08/2017] [Accepted: 06/25/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND As well as being a very common neurological disease worldwide, epilepsy significantly impairs patients' emotional, behavioral, and cognitive functioning. Sleep disturbances are the most frequent complaint in patients with epilepsy. The present study assesses the impact of a range of affective symptoms on subjective sleep quality and sleep disturbances in Chinese adults with epilepsy. METHODS Adults with epilepsy who visited our epilepsy clinic from July 2015 to March 2016 were enrolled in our study. Both patients and healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Mini-mental State Examination (MMSE). Subjective sleep quality and sleep disturbances were examined with regard to self-reported symptoms of depression and anxiety, seizure-related factors, and demographic factors. RESULTS The PSQI scores and ISI scores of patients were significantly higher (indicating lower quality sleep and more serious insomnia) than those of the control group. Symptoms associated with depression and anxiety were independently related to impaired subjective sleep quality and insomnia. Affective symptoms explained more of the variance in PSQI scores and ISI scores than did seizure-related or demographic variables. In addition, these variables also seemed to be less powerful contributing factors to subjective sleep quality and insomnia than affective symptoms, several seizure-related factors, such as seizure control, partial seizures and duration of epilepsy, which are also significantly associated with subjective sleep quality and insomnia. In addition, use of lamotrigine (LTG) was also associated with insomnia and use of clonazepam (CZP) and phenobarbital (PB) with daytime sleepiness in patients with epilepsy. CONCLUSION Chinese adults with epilepsy have poorer self-reported subjective sleep quality and a higher prevalence of insomnia than the control group. Depressive- and anxiety-related symptoms independently exert an adverse effect on the subjective sleep quality and insomnia of patients. In addition, seizure control, partial seizures, and the duration of epilepsy affect the quality of sleep and insomnia in patients, but seem less powerful predictors of sleep quality and insomnia than affective symptoms. Early identification and treatment of affective symptoms is of great importance in improving the sleep quality and insomnia of patients with epilepsy.
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Affiliation(s)
- Yeru Shen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Mengmeng Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Lanlan Wang
- Anhui Provincial Stereotactic Neurosurgical Institute, Anhui Provincial Hospital, Hefei, Anhui Province, PR China
| | - Xiangjun Xu
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, PR China
| | - Gairong Xiao
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Jing Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Ting Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Nong Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China.
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12
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Jiang Y, Tang YR, Xie C, Yu T, Xiong WJ, Lin L. Influence of sleep disorders on somatic symptoms, mental health, and quality of life in patients with chronic constipation. Medicine (Baltimore) 2017; 96:e6093. [PMID: 28207519 PMCID: PMC5319508 DOI: 10.1097/md.0000000000006093] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Sleep disturbance is a common symptom in CC patients, and it is positively related to greater somatic and psychiatric symptoms. METHODS The participants were 126 adult outpatients with CC. The measures were: constipation-Constipation Scoring System (CSS) and Patient Assessment of Constipation-Symptoms (PAC-SYM); sleep-Pittsburgh Sleep Quality Index (PSQI); anxiety-General Anxiety Disorder-7 (GAD-7); depression-Patient Health Questionnaire-9 (PHQ-9); and QOL-Patient Assessment of Constipation Quality of Life (PAC-QOL) and SF-36. Patients were divided into sleep-disorder and normal-sleep groups by their PSQI scores. RESULTS The sleep-disorder group had significantly higher rates of incomplete defecation and blockage and higher CSS scores, PAC-SYM total scores, and PAC-SYM rectal-item scores than the normal-sleep group. GAD-7 and PHQ-9 scores were significantly higher in patients with poor sleep. Furthermore, sleep disorders, depression, and anxiety were all positively correlated with constipation severity. "Worry/anxiety" score of PAC-QOL scale was significantly higher and scores for seven SF-36 subscales were significantly lower in patients with poor sleep. In addition, correlation analyses showed significant negative relations between QOL and constipation, sleep disturbance, anxiety as well as depression. However, multiple regression revealed that PAC-QOL was positively associated with severe constipation and SF-36 was negatively associated with anxiety and depression. But sleep disturbance was not the independent risk factor for QOL of CC patients. CONCLUSION Sleep disorders may worsen the physical- and mental health of CC patients. Sleep disturbance may lower CC patients' QOL indirectly through the combined effects of anxiety, depression, and constipation.
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13
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Staniszewska A, Mąka A, Religioni U, Olejniczak D. Sleep disturbances among patients with epilepsy. Neuropsychiatr Dis Treat 2017; 13:1797-1803. [PMID: 28744129 PMCID: PMC5513823 DOI: 10.2147/ndt.s136868] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM The aim of this study was to analyze the prevalence of sleep disorders among patients with epilepsy and to compare the incidence of sleep disorders between the clinical and demographics factors. MATERIALS AND METHODS The study was conducted among 302 patients with epilepsy. Sleep disturbances were measured with the Polish version of the Pittsburgh Sleep Quality Questionnaire (PSQI). The questionnaire prepared and applied by the authors contained questions relating to sociodemographic characteristics, clinical status, and sleep. RESULTS AND CONCLUSION Mean PSQI score in the study group was 9±2 points, with the range of 4-16 points. PSQI test results were analyzed with regard to clinical and demographic characteristics of those suffering from epilepsy: gender, age, profession, body mass index, illness duration, number of medicines taken, type of seizures, frequency of seizures, time which elapsed since last seizure, provocative factor of seizure attacks, occurrence of adverse effects of antiepileptic drugs (AEDs). Furthermore, the existence of a relationship between PSQI test result and particular sleep-related factors or particular sleep conditions was examined. However, the examination of a relationship between certain independent variables and the final PSQI test result did not prove the existence of a statistically relevant influence (in all cases P>0.05).
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Affiliation(s)
- Anna Staniszewska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Mąka
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Religioni
- Collegium of Socio-Economics, Warsaw School of Economics, Warsaw, Poland
| | - Dominik Olejniczak
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
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