Epilepsy and Sleep Disorders

2011 ◽  
Vol 6 (1) ◽  
pp. 60 ◽  
Author(s):  
Matthew C Walker ◽  
Sofia H Eriksson ◽  
◽  
Keyword(s):  
Sleep Disorders ◽  
Seizure Control ◽  
Close Association ◽  
Epileptic Seizures ◽  
Sleep Apnoea ◽  
Appropriate Treatment ◽  
Antiepileptic Medication ◽  
Obstructive Sleep ◽  
Patients With Epilepsy ◽  
Nocturnal Seizures

There is a close association between sleep and epilepsy. In some epilepsy syndromes, seizures occur predominantly (or even exclusively) during sleep or on awakening. Excessive daytime sleepiness is common in patients with epilepsy and may be due not only to medication but also to nocturnal seizures or concomitant sleep disorders. Sleep disorders such as obstructive sleep apnoea can worsen epilepsy, with improvement of seizure control following appropriate treatment of the sleep disorder. Conversely, epilepsy and antiepileptic medication can worsen sleep disorders. Nocturnal epileptic seizures may be difficult to differentiate from parasomnias, in particular non-rapid eye movement parasomnias such as night terrors, sleepwalking and confusional arousals, on history alone since there are semiological similarities between the two disorders. Schemes have been developed to facilitate differential diagnosis, although this remains a challenge even using the gold standard, video-electroencephalography telemetry.

Epilepsy and Sleep Disorders

US Neurology ◽  
2011 ◽  
Vol 07 (01) ◽  
pp. 60
Author(s):  
Matthew C Walker ◽  
Sofia H Eriksson ◽  
◽  
Keyword(s):  
Sleep Disorders ◽  
Seizure Control ◽  
Close Association ◽  
Epileptic Seizures ◽  
Night Terrors ◽  
Appropriate Treatment ◽  
Antiepileptic Medication ◽  
Obstructive Sleep ◽  
Patients With Epilepsy ◽  
Nocturnal Seizures

There is a close association between sleep and epilepsy. In some epilepsy syndromes, seizures occur predominantly (or even exclusively) during sleep or on awakening. Excessive daytime sleepiness is common in patients with epilepsy and may be due not only to medication but also to nocturnal seizures or concomitant sleep disorders. Sleep disorders such as obstructive sleep apnea can worsen epilepsy, with improvement of seizure control following appropriate treatment of the sleep disorder. Conversely, epilepsy and antiepileptic medication can worsen sleep disorders. Nocturnal epileptic seizures may be difficult to differentiate from parasomnias, in particular non-rapid eye movement parasomnias such as night terrors, sleepwalking and confusional arousals, on history alone since there are semiologic similarities between the two disorders. Schemes have been developed to facilitate differential diagnosis, although this remains a challenge even using the gold standard, video-electroencephalography telemetry.

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 The patient with epilepsy and medicolegal aspects: a view for the neurologist

2019 ◽  
Vol 77 (10) ◽  
pp. 741-745
Author(s):  
Amur FERREIRA NETO SEGUNDO ◽  
Maren de Moraes e SILVA ◽  
Pilar Bueno Siqueira MERCER ◽  
Carolina REINERT ◽  
Emerson Faria BORGES ◽  
...  
Keyword(s):  
Interpersonal Relationships ◽  
Epileptic Seizures ◽  
Federal Law ◽  
Employment Agreement ◽  
Antiepileptic Medication ◽  
Driver's License ◽  
The Individual ◽  
License Renewal ◽  
Attending Physician ◽  
Patients With Epilepsy

ABSTRACT Patients with epilepsy face innumerable obstacles in daily life, related to work, permission to drive and interpersonal relationships, which require medical guidance. This paper reports a literature review based on scientific articles and civil and traffic system, as a way to resolve doubts about medical obligations in the patient’s permission to drive and work. An employment agreement requires the contractor to guarantee safety conditions as well as requiring the patient, at the pre-employment medical examination, to let the physician know previous medical conditions, including epilepsy. More than 90% of patients with epilepsy omit this information during the application assessment, thus being subject to imputation of ideological falsehood crime as disposied on article 299 of Brazilian Penal Code. Medical confidentiality breaches may only occur in specific situations. In Brazil, the authorization and driver’s license renewal is governed by the Brazilian Traffic Code (Federal Law n° 9503/1997). For patient evaluations, two groups are considered: those on antiepileptic medication and those on medication withdrawal. A favorable report from the attending physician is also required, in both categories. Seizures that occur exclusively during sleep, and focal aware events or prolonged aura are not differentiated from other seizure types disposed in the traffic law. It is the responsibility of the attending physician to analyze each patient individually to resolve conflicts between public safety and the individual patient’s independence. A frank and honest doctor-patient relationship is essential for the patient to understand the public and individual consequences of epileptic seizures and to feel comfortable seeking medical help.

scholarly journals The effects of epileptic seizures upon quality of life

2009 ◽  
Vol 15 (3) ◽  
pp. 110-113 ◽  
Author(s):  
Priscila Camile Barioni Salgado ◽  
Fernando Cendes
Keyword(s):  
Quality Of Life ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Epileptic Seizures ◽  
Anxiety And Depression ◽  
Co Morbidity ◽  
Item Quality ◽  
Patients With Epilepsy ◽  
And Control

OBJECTIVE: understand the psychological considerations of the relationship between the effect of seizures upon the patients' perception of seizure control, depression, anxiety and quality of life (QoL). METHODS: 151 adult patients with epilepsy diagnosed for over two years were interviewed and responded the 31-Item Quality of Life in Epilepsy (QOLIE-31), the Trait Form of the State/Trait Anxiety Inventory (STAI II) and the Beck Depression Inventory (BDI). RESULTS: 45 patients were depressed (29.8%) and 29 (19.2%) had anxiety. Depression scores ranged from 0 to 49 (M=7.4; SD=8.9) and anxiety scores ranged from 19 to 69 (M=41.5, SD=11.9). Total QoL score was correlated to seizure control (p<0.001), perception of epilepsy control (p<0.001), anxiety (p<0.001), and depression (p=0.003). The perception of epilepsy control was correlated to seizure control (p<0.001), seizure frequency (p=0.001), anxiety (p<0.001) and depression (p<0.001). Seizure control was associated to anxiety (p=0.033) and depression (p<0.001). There was co-morbidity between anxiety and depression (p<0.001). CONCLUSION: This study highlights the importance of the seizure frequency and control to the evaluation of perception of epilepsy control and shows that anxiety and depression in epilepsy are predicted by seizure-related (seizure frequency and control) and psychosocial aspects (perception of control and QoL) together.

scholarly journals Sleep disorders in psychiatry

2018 ◽  
Vol 24 (4) ◽  
pp. 273-283 ◽  
Author(s):  
Hugh Selsick ◽  
David O'Regan
Keyword(s):  
Mental Health ◽  
Sleep Disorders ◽  
Sleep Medicine ◽  
Sleep Apnoea ◽  
Learning Objectives ◽  
List Type ◽  
Obstructive Sleep ◽  
Psychiatric Conditions ◽  
Respiratory Conditions ◽  
Broad Understanding

SUMMARYSleep medicine is a truly multidisciplinary field that covers psychiatric, neurological and respiratory conditions. As the field has developed it has become increasingly clear that there is a great deal of overlap between sleep and psychiatric disorders and it is therefore essential for psychiatrists to have some knowledge of sleep medicine. Even those disorders, such as obstructive sleep apnoea, that may seem to be outside the remit of psychiatry can have complex and important interactions with psychiatric conditions. In this article we give a brief overview of the range of sleep disorders a psychiatrist might encounter, how they are recognised, investigated and treated, and how they relate to psychiatric conditions.LEARNING OBJECTIVES•Be aware of the range of sleep disorders that might be encountered in psychiatric practice•Understand how these sleep disorders affect mental health•Have a broad understanding of how these disorders are investigated and treatedDECLARATION OF INTERESTH.S. has accepted speaker fees from Janssen Pharmaceuticals.

scholarly journals Modafinil in the treatment of selected sleep disorders

2021 ◽  
Vol 21 (3) ◽  
pp. 213-218
Author(s):  
Wacław Dyrda ◽  
Daria Smułek ◽  
Adam Wichniak ◽  
Keyword(s):  
Quality Of Life ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Shift Work ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Shift Work Sleep Disorder ◽  
Obstructive Sleep ◽  
Idiopathic Hypersomnia

Until 2010, modafinil, which is a wakefulness promoting agent, was approved in Europe for a wider spectrum of indications, such as narcolepsy, idiopathic hypersomnia, obstructive sleep apnoea and shift work sleep disorder. Currently, it is registered by the European Medicines Agency only for the treatment of narcolepsy, and is used as an off-label therapy in other sleep disorders. This paper presents the efficacy of modafinil in selected sleep disorders. Modafinil remains first-choice treatment for narcolepsy. It reduces the frequency of bouts of inadvertent sleep and nap episodes, the duration and intensity of daytime hypersomnolence, and also significantly improves the quality of life of patients. However, it is associated with only a slight improvement in cataplexy and other symptoms. In idiopathic hypersomnia, modafinil reduces the frequency of naps and unintentional sleep episodes, as well as subjective sleepiness measured with the Epworth Sleepiness Scale. Furthermore, the drug is used to treat hypersomnia from obstructive sleep apnoea in the case of lack of improvement despite optimal positive airway pressure therapy. Modafinil is also approved by the U.S. Food and Drug Administration for the treatment of shift work sleep disorder. The drug has been shown to reduce the level of somnolence, but it has not been found to reduce unintentional sleep episodes, reported mistakes or accidents at work. Given the strong negative impact of hypersomnolence on performance at work and school, the risk of accidents and the quality of life, the risk-benefit assessment of modafinil often justifies its use in the treatment of hypersomnolence also outside the approved indications.

scholarly journals The Managements and alternative therapies for comorbid sleep disorders in epilepsy

2020 ◽  
Vol 19 ◽  
Author(s):  
Weifeng Peng ◽  
Jing Ding ◽  
Xin Wang
Keyword(s):  
Sleep Disorders ◽  
Behavioral Therapy ◽  
Alternative Therapies ◽  
Cochrane Library ◽  
Sleep Stages ◽  
Complementary And Alternative Therapies ◽  
Epileptiform Discharges ◽  
Obstructive Sleep ◽  
Patients With Epilepsy ◽  
Complementary And Alternative

Background: There is a complex and interactive relationship between sleep and epilepsy. Sleep disorders are common in patients with epilepsy, and methods for managing sleep disorders in patients with epilepsy are limited. Objective: This review is to address the relationships among sleep, sleep disorders, and epilepsy, focusing on the managements for sleep disorders in epilepsy, including some complementary and alternative therapies. Methods: The terms related to “sleep” and “epilepsy” were searched in “Pubmed” and “Cochrane Library”. Results: Sleep stages differently affects both of seizures and interictal epileptiform discharges. Seizures disrupt sleep architectures greatly, especially when arising from sleep in the night. Insomnia and obstructive sleep apnea (OSA) are the most frequent types of comorbid sleep disorders in patients with epilepsy. Pharmacological agents with both anti-convulsant and sedative effects are the priorities for comorbid sleep disorders in epilepsy. Continuous positive airway pressure (CPAP) therapy is the most effective non-pharmacological method to improve OSA and reduce seizures. Complementary and alternative therapies such as Chinese traditional medicine, cognitive behavioral therapy, meditation, yoga, neurofeedback, and acupuncture may have benefits on reducing seizures and improving sleep quality simultaneously by alleviating stress and seizure triggers, however, evidence-based therapies are still in deficiency. Conclusion: Managements for sleep disorders in patients with epilepsy are challenging. Large sample randomized controlled trials are in demand in the future.

scholarly journals Electronic health record cue identifies epilepsy patients at risk for obstructive sleep apnea

2018 ◽  
Vol 8 (6) ◽  
pp. 468-471 ◽  
Author(s):  
Martha A. Mulvey ◽  
Aravindhan Veerapandiyan ◽  
David A. Marks ◽  
Xue Ming
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Electronic Health Record ◽  
Seizure Control ◽  
Health Record ◽  
Obstructive Sleep ◽  
Patients At Risk ◽  
Patients With Epilepsy

BackgroundPrior studies have reported that patients with epilepsy have a higher prevalence of obstructive sleep apnea (OSA) that contributes to poor seizure control. Detection and treatment of OSA can improve seizure control in some patients with epilepsy. In this study, we sought to develop, implement, and evaluate the effectiveness of an electronic health record (EHR) alert to screen for OSA in patients with epilepsy.MethodsA 3-month retrospective chart review was conducted of all patients with epilepsy >18 years of age who were evaluated in our epilepsy clinics prior to the intervention. An assessment for obstructive sleep apnea (AOSA) consisting of 12 recognized risk factors for OSA was subsequently developed and embedded in the EHR. The AOSA was utilized for a 3-month period. Patients identified with 2 or more risk factors were referred for polysomnography. A comparison was made to determine if there was a difference in the number of patients at risk for OSA detected and referred for polysomnography with and without an EHR alert to screen for OSA.ResultsThere was a significant increase in OSA patient recognition. Prior to the EHR alert, 25/346 (7.23%) patients with epilepsy were referred for a polysomnography. Postintervention, 405/414 patients were screened using an EHR alert for AOSA and 134/405 (33.1%) were referred for polysomnography (p < 0.001).ConclusionAn intervention with AOSA cued in the EHR demonstrated markedly improved identification of epilepsy patients at risk for OSA and referral for polysomnography.

scholarly journals Misdiagnosing sleep disorders as primary psychiatric conditions

2003 ◽  
Vol 9 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Gregory Stores
Keyword(s):  
Sleep Disorders ◽  
Sleep Apnoea ◽  
Excessive Sleepiness ◽  
Delayed Sleep Phase Syndrome ◽  
Obstructive Sleep ◽  
Wide Range ◽  
Delayed Sleep Phase ◽  
Psychiatric Conditions ◽  
Delayed Sleep ◽  
Cycle Disorders

Sleep disorders are relevant to psychiatric practice in a number of ways, including the possibility that they may be misdiagnosed as fundamentally psychiatric conditions in patients of all ages. This risk exists in a wide range of collectively very common sleep disorders which need to be considered in explaining insomnia, excessive sleepiness or disturbed episodes of behaviour associated with sleep (parasomnias). Examples given include circadian sleep–wake cycle disorders (such as the delayed sleep phase syndrome), obstructive sleep apnoea, narcolepsy, Kleine–Levin syndrome, sleep paralysis and rapid eye movement (REM) sleep behaviour disorder. Failure to recognise and treat such disorders is likely to cause and perpetuate psychological problems. Correct recognition requires familiarity with the range and manifestations of sleep disorders.

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