Sleep and epilepsy—chicken or egg?

2018 ◽  
Author(s):  
Dora A. Lozsadi
Keyword(s):  
Side Effects ◽  
Sleep Disorders ◽  
Learning Disability ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Seizure Control ◽  
Subjective Sleep ◽  
Neurological Conditions ◽  
The Uk ◽  
Patients With Epilepsy

Epilepsy is the commonest serious chronic neurological condition, affecting 0.5% of the population in the UK. Subjective sleep disturbance and excessive daytime sleepiness are reported to be 50% more frequent in those with epilepsy than in controls. Causes are multiple. Both poor seizure control and nocturnal attacks are known to contribute to such sleep disorders. Epilepsy also increases the risk of associated sleep disorders, and additional neurological conditions, such as dementia, learning disability, and depression. These all affect sleep hygiene. Prescribed anti-epileptic drugs will further aggravate the problem. Side-effects will include drowsiness. Sedating benzodiazepines and barbiturates are considered worst offenders. Others affect sleep architecture to varying degrees and/or cause insomnia. While hyper-somnolence in patients with epilepsy will raise the possibility of any of the above issues, sleep deprivation is one of the commonest seizure triggers. This chapter will shed more light on the intricate relationship between sleep and epilepsy.

scholarly journals Excessive Daytime Sleepiness and Epilepsy: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Andre S. Giorelli ◽  
Pâmela Passos ◽  
Thiago Carnaval ◽  
Marleide da Mota Gomes
Keyword(s):  
Systematic Review ◽  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Related Factors ◽  
Cross Sectional ◽  
Sleep Complaints ◽  
Number Of Children ◽  
Pubmed Database ◽  
Patients With Epilepsy

Background. Sleep complaints are common in patients with epilepsy (PWE). Excessive daytime sleepiness (EDS) is one of the most reported complaints and its impact is still a matter of debate. Objective. Evaluate the relationship between EDS and epilepsy, with emphasis on prevalence, assessment, and causes. Methods. A systematic review on PubMed database in the last 10 years (2002 to 2012). The search returned 53 articles and 34 were considered relevant. After citation analysis, 3 more articles were included. Results. Most studies were cross-sectional and questionnaire based. 14 papers addressed EDS as the primary endpoint. 14 adult and 3 children studies used subjective and objective analysis as methodology. The number of studies increased throughout the decade, with 21 in the last 5 years. Adult studies represent almost three times the number of children studies. EDS prevalence in PWE varies from 10 to 47.5%. Prevalence was higher in developing countries. Conclusion. EDS seems to be related more frequently to undiagnosed sleep disorders than to epilepsy-related factors, and although it affects the quality of life of PWE, it can be improved by treating comorbid primary sleep disorders.

scholarly journals Effects of Levetiracetam on Sleep Architecture and Daytime Sleepiness

Folia Medica ◽  
2021 ◽  
Vol 63 (5) ◽  
pp. 631-636
Author(s):  
Orlina Chaneva
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Seizure Control ◽  
Epileptic Activity ◽  
Small Sample ◽  
Sleep Architecture ◽  
Direct Result ◽  
Patients With Epilepsy

Sleep is a reversible behavioural state of perceptual disengagement from and unresponsiveness to the environment, which is required for neural plasticity and memory consolidation. Sleep disorders are common in patients with epilepsy. The main causes of sleep disturbances are coexisting sleep disorders, impact of seizures and epileptic activity, and the effects of antiepileptic drugs. Sleep and epilepsy have reciprocal effects – on one hand electrical brain activity during sleep is a strong modulator of epileptic activity and on the other epileptic activity during sleep may disrupt sleep architecture. The most common side effects of anticonvulsants include alterations in sleep architecture and variation in the degree of daytime sleepiness. Their effects on sleep and daytime sleepiness are variable and it is often difficult to distinguish whether the improved seizure control and epileptic activity is a direct result of anticonvulsants or associated with improved sleep quality. Levetiracetam is a new generation anticonvulsant used to treat both focal and generalized epilepsy. Its satisfactory safety and tolerability explain its wide usage in the clinical practice and necessitates more profound knowledge on its effects on sleep quality. There have been few reports about its effects on sleep architecture and daytime sleepiness. A short summary of the studies concerning this topic is presented. Main disadvantages of the studies are: the small sample size, comparison of the results obtained in healthy volunteers with patients with epilepsy, short observation duration, variations of dosage, different evaluation modalities and concomitant AED therapy. Future prospective studies on subjective and objective effects of Levetiracetam on sleep architecture and daytime sleepiness are needed to better understand its impact on sleep in order to improve epilepsy patients’ quality of life, seizure control and sleep disturbances.

scholarly journals Excessive Daytime Sleepiness and Sleep Disorders in a Population of Patients with Epilepsy: a Case-Control Study

2016 ◽  
Vol 6 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Matilde Gammino ◽  
Leila Zummo ◽  
Anna Lo Bue ◽  
Lidia Urso ◽  
Valeria Terruso ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Case Control Study ◽  
Case Control ◽  
Patients With Epilepsy ◽  
Control Study

scholarly journals Sleep disorders in pregnancy

2004 ◽  
Vol 62 (2a) ◽  
pp. 217-221 ◽  
Author(s):  
Eliane Aversa Lopes ◽  
Luciane Bizari Coin de Carvalho ◽  
Priscila Bernal da Costa Seguro ◽  
Rosiane Mattar ◽  
Ademir Baptista Silva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Clinical Interview ◽  
Human Beings ◽  
Normal Sleep ◽  
Function Of Sleep ◽  
In Pregnancy ◽  
Sleep In Animals

CONTEXT: The precise function of sleep in animals and human beings is still unknown, and any sort of physical, social or psychological variation may change the normal sleep-wake cycle. PURPOSE: This research aims is to determine the sleep disorders (SD) for each of the three trimesters of the pregnancy comparing them to the pre-pregnancy state (PG). METHOD: SD were investigated in three hundred pregnant women 11- to 40-years-old through with a brief clinical interview based on directed questions. One hundred pregnant women were considered for each trimester. RESULTS: The rate of pregnant women with insomnia increased by 23% in the 2nd trimester (p< 0.005); the rate for excessive daytime sleepiness (EDS) by 15% in the 1st trimester (p<0.003), 55% in the 2nd trimester (p<0.001) and by 14% in the 3rd trimester (p<0.002); the rate for mild sleepiness increased by 33% in the 2nd trimester (p<0.002) and by 48% in the 3rd trimester (p<0.001); the rate for specific awakenings increased by 63% in the 1st trimester, by 80% in the 2nd trimester and by 84% in the 3rd trimester (p<0.001). CONCLUSION: SD were more frequent during pregnancy comparatively to PG state, mostly at the expenses of EDS and specific awakenings.

P0963MANAGEMENT OF SLEEP DISORDERS IN END-STAGE RENAL DISEASE, IS IT REALLY IMPORTANT?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Liliana-Ana Tuta ◽  
Tofolean Doina-Ecaterina ◽  
Tudor Alexandra ◽  
Campineanu Bogdan
Keyword(s):  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
End Stage Renal Disease ◽  
Daytime Sleepiness ◽  
Fluid Overload ◽  
Sleep Apnoea ◽  
Refractory Hypertension ◽  
P Values ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Sleep apnoea (SA), either obstructive and central (OSA and CSA, respectively) associated with and excessive daytime sleepiness (EDS) are common sleep disorders among patients with end-stage renal disease (ESRD). Fluid overload characterizes end-stage kidney disease and plays an important role in the pathogenesis of OSA, CSA and EDS. In our study we assessed the prevalence of sleep apnoea and excessive daytime sleepiness in patients from a nephrology and dialysis unit from south-eastern Romania. Method 86 patients with ESRD pre-dialysis (eGFR &lt; 15 ml/min/1,73 m) or on maintenance haemodialysis were monitored for an interval of 2 years. We used questionnaires to assess the prevalence of SA and EDS. All subjects underwent overnight polysomnography (PSG). Extracellular fluid volume of the total body, neck, thorax and right leg were measured using bioelectrical impedance. We also examined the association between sleep apnoea, EDS, the underlying causes of ESRD, co-morbidities, medication used, and other demographic data. Results The mean patients age was 57.5 years ± 14.9 years; 65.1% were male, and 34.9% were female. The prevalence of SA as defined by the Berlin questionnaire (BQ) was 49.5% in males and 34.8% in females, which was not a statistically significant difference (P = 0.029). Sleep apnoea was significantly associated with age, obesity, diabetes, hypertension, fluid overload and 2nd or 3rd haemodialysis shift (P-values, 0.001, &lt; 0.0001, &lt; 0.002, &lt; 0.008, &lt;0.0001, and &lt; 0.005. Sleep apnoea was also significantly associated with other sleep disorders such as restless leg syndrome, insomnia, habitual snoring, and EDS (P-values, &lt; 0.001, &lt; 0.001, &lt; 0.001, and &lt; 0.001, respectively). The prevalence of EDS was 35,5%, and EDS was significantly associated with age (over 60 years old), diabetes mellitus, hypertension and obesity. 18 patients (20.9%) had refractory hypertension, that improved after CPAP administration, and 10 of these patients (over 50% with refractory HT), that refused the application of appropriate therapy of sleep disorders, suffered a major cardiovascular event during our study. Conclusion Sleep apnoea, excessive daytime sleepiness and other sleep disorders are relatively common in pre-dialysis and haemodialysis patients and are significantly associated with refractory hypertension and severe cardio-vascular events. That is why a greater attention should be given to the diagnosis and management of sleep disorders, as one of the important steps in nursing and our patients’ rehabilitation.

scholarly journals The Epworth Sleepiness Scale in Service Members with Sleep Disorders

2019 ◽  
Vol 184 (11-12) ◽  
pp. e701-e707 ◽  
Author(s):  
April Hurlston ◽  
Shannon N Foster ◽  
Jennifer Creamer ◽  
Matthew S Brock ◽  
Panagiotis Matsangas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Military Personnel ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Epworth Sleepiness Scale ◽  
Clinical Utility ◽  
Obstructive Sleep ◽  
The Military

ABSTRACTIntroductionExcessive daytime sleepiness affects an estimated 20% of the general population. While the prevalence of sleepiness in the military is largely unknown, it is well established that short sleep duration is endemic. The reasons for this include: the demanding nature of their duties, shift work and 24-hour duty periods, deployments and exigencies of military service as well as sleep disorders. The Epworth Sleepiness Scale (ESS) is the most widely used sleep questionnaire and provides a self-assessment of daytime sleepiness. To date the clinical utility of this questionnaire in differentiating sleep disorders in military patients with sleep disorders has never been evaluated.Materials and MethodsThe primary aim of this manuscript was to assess if Epworth Sleepiness Scale (ESS) scores differed between military personnel with insomnia, obstructive sleep apnea (OSA), comorbid insomnia/obstructive sleep apnea (COMISA), and a group with neither insomnia nor obstructive sleep apnea (NISA). This study assessed the clinical utility of the ESS in differentiating sleep disorders amongst a sample (N = 488) of U.S. military personnel with insomnia (n = 92), OSA (n = 142), COMISA (n = 221), and a NISA group (n = 33) which served as the control population.ResultsIn the present sample, 68.4% of service members reported excessive daytime sleepiness (EDS) with an ESS &gt; 10. ESS scores differed between military personnel with COMISA (13.5 ± 4.83) and those with OSA only (11.5 ± 4.08; p &lt; 0.001) and the NISA group (9.46 ± 4.84; p &lt; 0.001). Also, ESS scores differed between patients with insomnia only (13.0 ± 4.84) and the NISA group (p &lt; 0.01).ConclusionsOverall, the ESS had poor ability to differentiate sleep disorders. In military personnel, the ESS appears elevated in the most common sleep disorders, likely due to their insufficient sleep, and does not help to differentiate OSA from insomnia. Further studies are required to validate this questionnaire and determine an appropriate threshold value for abnormal sleepiness in the military population.

Could a Virtual Human Be Used to Explore Excessive Daytime Sleepiness in Patients?

2014 ◽  
Vol 23 (4) ◽  
pp. 369-376 ◽  
Author(s):  
Pierre Philip ◽  
Stéphanie Bioulac ◽  
Alain Sauteraud ◽  
Cyril Chaufton ◽  
Jérôme Olive
Keyword(s):  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Affective Computing ◽  
Conversational Agents ◽  
Sleep Complaints ◽  
Daily Life Activities ◽  
Human Interactions ◽  
Falling Asleep ◽  
Excessive Daytime Somnolence

Excessive daytime somnolence (EDS) is defined as the inability to stay awake in daily life activities. Several scales have been used to diagnose excessive daytime sleepiness, the most widely used being the Epworth Sleepiness Scale (ESS). Sleep disorders and EDS are very common in the general population. It is therefore important to be able to screen patients for this symptom in order to obtain an accurate diagnosis of sleep disorders. Embodied Conversational Agents (ECA) have been used in the field of affective computing and human interactions but up to now no software has been specifically designed to investigate sleep disorders. We created an ECA able to conduct an interview based on the ESS and compared it to an interview conducted by a sleep specialist. We recruited 32 consecutive patients and a group of 30 healthy volunteers free of any sleep complaints. The ESS is a self-administered questionnaire that asks the subject to rate (with a pen and paper paradigm) his or her probability of falling asleep. For the purpose of our study, the ECA or real-doctor questionnaire was modified as follows: Instead of the “I” formulate, questions were asked as “Do you.” Our software is based on a common 3D game engine and several commercial software libraries. It can run on standard and affordable hardware products. The sensitivity and specificity of the interview conducted by the ECA were measured. The best results (sensibility and specificity >98%) were obtained to discriminate the sleepiest patients (ESS ≥16) but very good scores (sensibility and specificity >80%) were also obtained for alert subjects (ESS<8). ESS scores obtained in the interview conducted by the physician were significantly correlated with ESS scores obtained in the interview the ECA conducted. Most of the subjects had a positive perception of the virtual physician and considered the interview with the ECA as a good experience. Sixty-five percent of the participants felt that the virtual doctor could significantly help real physicians. Our results show that a virtual physician can conduct a very simple interview to evaluate EDS with very similar results to those obtained by a questionnaire administered by a real physician. The expected massive increase in sleep complaints in the near future likely means that more and more physicians will be looking for computerized systems to help them to diagnose their patients.

scholarly journals Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome

2015 ◽  
Vol 30 (1) ◽  
pp. 17-23
Author(s):  
Nikki Lorraine Y. King-Chao ◽  
Michael A. Sarte
Keyword(s):  
Body Mass Index ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obese Patients ◽  
Apnea Syndrome

Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI. Methods: Study Design:            Non-Concurrent Cohort Study Setting:                       Tertiary Private Hospital Population:                The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study. Results:The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05), even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05), representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of ³10. BMI wasalso significantly associated with AHI using one-way Anova test. Conclusion: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders, particularly OSAS. On the other hand, the ESS showed a significant association with BMI, representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is 2 times more for obese patients. BMI was also significantly associated with AHI, which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS. Keywords:obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index,  body-mass index.

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