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Ye L, Xu J, Chen C, Zhang L, Wang S. Effects of anti-seizure therapies on sleep in patients with epilepsy: A literature review. Acta Neurol Scand 2022; 146:767-774. [PMID: 36071677 DOI: 10.1111/ane.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/23/2022] [Indexed: 11/27/2022]
Abstract
Sleep disorder is common in epilepsy. With a recent rapid development in sleep medicine, it has been increasingly recognized that anti-seizure therapies, either anti-seizure medications (ASMs) or non-pharmaceutical approaches, can take direct or indirect influence on sleep in patients with epilepsy. Here, we systematically review the effect of anti-seizure treatments on sleep. ASMs targeting at different sites exerted various effects on both sleep structure and sleep quality. Non-pharmaceutical treatments including resective surgery, ketogenic diet, and transcranial magnetic stimulation appear to have a positive effect on sleep, while vagus nerve stimulation, deep brain stimulation, and brain-responsive neurostimulation are likely to interrupt sleep and exacerbate sleep-disordered breathing. The potential mechanisms underlying how non-pharmacological approaches affect sleep are also discussed. The limitation of most studies is that they were largely based on small cohorts by short-term observations. Further well-designed and large-scale investigations in this field are warranted. Understanding the effect of anti-seizure therapies on sleep can guide clinicians to optimize epilepsy treatment in the future.
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Affiliation(s)
- Lingqi Ye
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiahui Xu
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cong Chen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lisan Zhang
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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2
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Soliman SS, Sedik GA, Elghobashy MR, Zaazaa HE, Saad AS. Greenness Assessment Profile of a QbD Screen-Printed Sensor for Real-Time Monitoring of Sodium Valproate. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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3
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Effects of Obstructive Sleep Apnea on Epilepsy, and Continuous Positive Airway Pressure as a Treatment Option. J Clin Med 2022; 11:jcm11072063. [PMID: 35407671 PMCID: PMC8999241 DOI: 10.3390/jcm11072063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/17/2022] [Accepted: 04/02/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: To compare the characteristics of obstructive sleep apnea (OSA) between patients with epilepsy and patients without epilepsy and to investigate CPAP (Continuous Positive Airway Pressure) effect on seizures. Methods: Medical and polysomnography (PSG) data from 235 adult OSA patients with epilepsy (OE; 183 males; mean age, 49.8 years) and 268 age- and sex-matched OSA patients without epilepsy (OSE; 216 males; mean age, 51.3 years), obtained between March 2014 and May 2020 and housed in a database in a university-affiliated hospital, were retrospectively reviewed. All subjects completed surveys addressing comorbidities and medications, and sleep-related questionnaires including the Insomnia Severity Index, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Beck Depression Inventory-II. Results: Compared with the OSE group, the OE group reported fewer sleep-related complaints and less severe OSA-related PSG parameters, with a lower apnea-hypopnea index (24.9 vs. 33.4 events/h; p < 0.003), arousal index (23.3 vs. 30.8 events/h; p < 0.001), and oxygen desaturation index (19.6 vs. 28.8; p < 0.002). The OE group had fewer smokers and lower alcohol consumption but a higher body mass index (27.0 vs. 25.9 kg/m2; p < 0.001). No correlations were observed between OSA-related PSG parameters and epilepsy-related factors, such as age at seizure onset, seizure type, frequency of seizures, presence of nocturnal seizures, and number of antiseizure medications, in the OE group. Patients with OE who demonstrated good compliance with CPAP therapy exhibited a decrease in seizure frequency. Conclusions: The OE group exhibited less severe disease characteristics than their age- and sex-matched OSE counterparts. Nevertheless, because the coexistence of OSA and epilepsy is high, CPAP therapy can reduce the frequency of seizures. Therefore, it is important to evaluate the presence of OSA in patients with epilepsy and to treat the conditions concurrently.
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Özbek O, Isildak Ö, Isildak I. A potentiometric biosensor for the determination of valproic acid: Human blood–based study of an anti–epileptic drug. Biochem Eng J 2021. [DOI: 10.1016/j.bej.2021.108181] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Liguori C, Toledo M, Kothare S. Effects of anti-seizure medications on sleep architecture and daytime sleepiness in patients with epilepsy: A literature review. Sleep Med Rev 2021; 60:101559. [PMID: 34710770 DOI: 10.1016/j.smrv.2021.101559] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
Anti-seizure medications (ASMs) may improve or be detrimental to sleep. A literature review (as an update to the 2014 review by Jain and Glauser [https://doi.org/10.1111/epi.12478]) of 25 ASMs of interest (articles from 12 ASMs included) on the effect of ASMs/non-drug treatments on sleep in patients with epilepsy was conducted. The most common objective instrument was polysomnography, and the most common subjective measures were the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. Eslicarbazepine acetate, lacosamide, and perampanel improved or had no effect on sleep. Perampanel was associated with low incidence of insomnia, and lacosamide with low incidence of daytime sleepiness adverse events. Clonazepam, felbamate, lamotrigine, oxcarbazepine, and phenobarbital worsened or had no effect on sleep. Lamotrigine may be associated with insomnia risk and phenobarbital with daytime sleepiness. Data for valproic acid were mixed. Overall, cannabidiol, carbamazepine, and levetiracetam had no effect on sleep. Epilepsy surgery may benefit sleep in patients with a good surgical outcome. Some ASMs, and, possibly, epilepsy surgery, may have positive effects on sleep, possibly linked to achieving seizure control. Nonetheless, other ASMs may worsen sleep in some settings. Clinicians should consider such observations when making treatment decisions, particularly for patients with comorbid sleep disorders.
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Affiliation(s)
- Claudio Liguori
- Epilepsy Centre, Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Manuel Toledo
- Epilepsy Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Sanjeev Kothare
- Department of Pediatrics, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
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Guichard K, Micoulaud-Franchi JA, McGonigal A, Coulon P, Sureau C, Ghorayeb I, Salvo F, Philip P. Association of Valproic Acid With Central Sleep Apnea Syndrome: Two Case Reports. J Clin Psychopharmacol 2020; 39:681-684. [PMID: 31725092 DOI: 10.1097/jcp.0000000000001106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kelly Guichard
- Clinique du Sommeil, Bordeaux University Hospital (CHU), and Université de Bordeaux and CNRS, SANPSY, USR 3413, Bordeaux, France Clinique du Sommeil, Bordeaux University Hospital (CHU), and Université de Bordeaux and CNRS, SANPSY, USR 3413, Bordeaux, France Aix Marseille Univ, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France Clinique du Sommeil, Bordeaux University Hospital (CHU), Bordeaux, France Clinique du Tondu, Bordeaux, France Département de Neurophysiologie Clinique, Pôle Neurosciences Cliniques, CHU de Bordeaux and Université de Bordeaux, Institut de Neurosciences, Cognitives et Intégratives d'Aquitaine, UMR 5287, Bordeaux, France Bordeaux Population Health Research Center, Pharmacoepidemiology Team (UMR 1219), INSERM, University of Bordeaux, Bordeaux, France Clinique du Sommeil, Bordeaux University Hospital (CHU) and Université de Bordeaux and CNRS, SANPSY, USR 3413, Bordeaux, France
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Abstract
The aim of this study was to identify the prevalence of heightened risk for obstructive sleep apnea (OSA) and its clinical predictors in a heterogeneous diagnostic group of hospitalized psychiatric patients. Ninety-one consecutive psychiatric inpatients were administered the STOP-BANG and Epworth Sleepiness Scale (ESS) inventories. Medical and demographic information was gathered from inpatient clinical charts. Predictors of high OSA risk score were analyzed by a multivariate regression model. A total of 58.2% (53 patients) were determined to have a high risk for OSA. The predictors of high OSA risk were use of mood stabilizers, use of CNS depressants, use of CNS stimulants, and excessive daytime sleepiness measured by ESS. The risk of OSA was high in psychiatric inpatients, and particularly elevated in older patients and those taking commonly utilized psychiatric medications.
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Revol B, Jullian-Desayes I, Guichard K, Micoulaud-Franchi JA, Tamisier R, Philip P, Joyeux-Faure M, Pépin JL. Valproic acid and sleep apnoea: A disproportionality signal from the WHO pharmacovigilance database. Respirology 2020; 25:336-338. [PMID: 32000295 DOI: 10.1111/resp.13771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/18/2019] [Accepted: 12/10/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Bruno Revol
- HP2 Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Laboratoire EFCR, CHU Grenoble Alpes, Grenoble, France.,Centre Régional de Pharmacovigilance, CHU Grenoble Alpes, Grenoble, France
| | - Ingrid Jullian-Desayes
- HP2 Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Laboratoire EFCR, CHU Grenoble Alpes, Grenoble, France
| | - Kelly Guichard
- Clinique du Sommeil, CHU de Bordeaux, Bordeaux, France.,SANPSY, Université de Bordeaux, Bordeaux, France.,SANPSY USR 3413, CNRS, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Clinique du Sommeil, CHU de Bordeaux, Bordeaux, France.,SANPSY, Université de Bordeaux, Bordeaux, France.,SANPSY USR 3413, CNRS, Bordeaux, France
| | - Renaud Tamisier
- HP2 Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Laboratoire EFCR, CHU Grenoble Alpes, Grenoble, France
| | - Pierre Philip
- Clinique du Sommeil, CHU de Bordeaux, Bordeaux, France.,SANPSY, Université de Bordeaux, Bordeaux, France.,SANPSY USR 3413, CNRS, Bordeaux, France
| | - Marie Joyeux-Faure
- HP2 Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Laboratoire EFCR, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Pépin
- HP2 Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Laboratoire EFCR, CHU Grenoble Alpes, Grenoble, France
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Loveless JP, Russo JM, Andersen VC. The Successful Treatment of Insomnia in a Patient With a Complex Neurological History. Clin Case Stud 2019. [DOI: 10.1177/1534650119890123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Insomnia is one of the more common sleep–wake disorders from which people suffer. This is particularly true among individuals who have experienced neurological insult via conditions such as multiple sclerosis, stroke, and other neurodegenerative disorders. While cognitive-behavioral therapy for insomnia (CBT-I) is one of the most effective behavioral interventions for insomnia, there is a dearth of empirical literature on its application to patients who have a history of neurological disorders. The present case study illustrates a largely successful course of CBT-I to treat a persistent and severe case of insomnia for Eric, a 55-year-old Caucasian man with multiple sclerosis and a self-reported history of restless leg syndrome and stroke. His treatment course is described in detail, and the implications of this approach to care are discussed.
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Halal CDS, Horta BL, Nunes ML. Polysomnographic Aspects of Sleep Architecture on Self-limited Epilepsy with Centrotemporal Spikes: A Systematic Review and Meta-analysis. ACTA ACUST UNITED AC 2018; 10:161-167. [PMID: 29410748 PMCID: PMC5760050 DOI: 10.5935/1984-0063.20170028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Self-limited epilepsy with centrotemporal spikes is the most common paediatric epileptic syndrome, with growing evidence linking it to various degrees and presentations of neuropsychological dysfunction. The objective of this study is to evaluate the possible sleep macro and microstructural alterations in children with this diagnosis. A systematic review of published manuscripts was carried out in Medline, LILACS and Scielo databases, using the MeSH terms epilepsy, sleep and polysomnography. From 753 retrieved references, 5 were selected, and data from macro and, when available, microstructure of sleep were extracted. Meta-analysis was performed with data from 4 studies using standardized mean difference. Findings were heterogeneous between studies, being the most frequent macrostructural findings a smaller proportion and greater latency of REM sleep in two studies and, in meta-analysis, a longer sleep latency was the most significant finding among epileptic patients. Only one study evaluated sleep microstructure, suggesting possible alterations in cyclic alternating pattern in diagnosed children. Studies evaluating macro and microstructure of sleep in children with self-limited epilepsy with centrotemporal spikes are necessary to a better understanding of mechanisms of the neuropsychologic disturbances that are frequently seen in children with this diagnosis.
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Affiliation(s)
- Camila Dos Santos Halal
- Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), PhD Program of Medicine and Health Sciences - Porto Alegre - Rio Grande do Sul - Brazil.,Conceição Hospital Group, Hospital Criança Conceição - Porto Alegre - Rio Grande do Sul - Brazil
| | - Bernardo Lessa Horta
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology, Pelotas, Rio Grande do Sul, Brazil
| | - Magda Lahorgue Nunes
- Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine and Brain Institute (BRAIns), Division of Neurology, Porto Alebre, Rio Grande do Sul, Brazil
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Shi Y, Dong J, Tang L, Kang R, Shi J, Zhang J. N6-(3-methoxyl-4-hydroxybenzyl) adenine riboside induces sedative and hypnotic effects via GAD enzyme activation in mice. Pharmacol Biochem Behav 2014; 126:146-51. [DOI: 10.1016/j.pbb.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 08/24/2014] [Accepted: 09/06/2014] [Indexed: 12/24/2022]
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