Co-morbid sleep disorders and epilepsy: A narrative review and case examples

Latreille, Véronique; Louis, Erik K. St.; Pavlova, Milena

doi:10.1016/j.eplepsyres.2018.07.005

Cited by 31 publications

(16 citation statements)

References 87 publications

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“…In men with epilepsy, poor sleep is the most dangerous factor in comorbid anxiety disorders. Sleep problems occur more frequently in PWE than in healthy controls (24). Sleep disturbance is a well-documented risk factor for developing or worsening anxiety disorders (25,26), and women in the general population are more likely than men to report insomnia (25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Associated and Predictive Factors of Anxiety and Depression in People With Epilepsy

et al. 2020

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Purpose Comorbid anxiety and depression in people with epilepsy (PWE) are highly prevalent and contribute to low quality of life (QOL) and may even lead to poor outcomes of epilepsy. Among the various factors that affect these negative emotional comorbidities, possible gender differences remain poorly understood and are often neglected. This research aimed to determine whether there are discrepancies in the incidence and influence factors of anxiety and depression between men and women with epilepsy in a hospital in northwest China. Methods A total of 158 adult PWE (female: N = 65; 41.1%) completed self-report questionnaires, including the Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), the Chinese version of the Quality of Life in Epilepsy-31 (QOLIE-31) inventory and the Pittsburgh Sleep Quality Inventory (PSQI). The comparison between male and female PWE was made by regression analysis. Results For the prevalence of anxiety and depression in PWE, no gender difference was found in this study. However, the moderating factors of psychiatric comorbidities were significantly different between men and women: male PWE with comorbid anxiety were more likely to be affected by sleep quality, while anxiety symptoms in female PWE were closely associated with the frequency of seizures. Education years and QOL social function were significant indicators of depression in male PWE but not in female PWE. The important and common predictor for anxiety and depressive symptoms in PWE was QOL energy/fatigue, with male patients being more affected. Conclusion For the PWE included in this study, the incidence of comorbid anxiety and depression in PWE was similar for men and women, but the moderating factors affecting comorbid anxiety and depressive disorders differed between genders: male PWE were more likely to be affected by psychosocial factors, while female PWE were more influenced by epilepsy itself. This exploration suggests that gender-specific health care should be considered in epilepsy therapy to improve the psychiatric condition and QOL of PWE, and different treatments should be conducted for male and female PWE to prevent negative emotional comorbidities.

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Section: Discussionmentioning

confidence: 99%

Gender Differences in Associated and Predictive Factors of Anxiety and Depression in People With Epilepsy

et al. 2020

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“…Most of the evidence on the important relationship between sleep and epilepsy relates to the modulation of epileptic activity (EA) by vigilance stages and circadian factors, as well as to the influence on epilepsy of sleep deprivation and sleep disorders 1–3 . In contrast, consequences of epilepsy on sleep are less well studied, albeit sleep complaints are common in patients with epilepsy 4 .…”

mentioning

confidence: 99%

Sleep Disruption in Epilepsy: Ictal and Interictal Epileptic Activity Matter

Peter‐Derex

Klimeš

Latreille

et al. 2020

Annals of Neurology

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Objective: Disturbed sleep is common in epilepsy. The direct influence of nocturnal epileptic activity on sleep fragmentation remains poorly understood. Stereo-electroencephalography paired with polysomnography is the ideal tool to study this relationship. We investigated whether sleep-related epileptic activity is associated with sleep disruption. Methods: We visually marked sleep stages, arousals, seizures, and epileptic bursts in 36 patients with focal drugresistant epilepsy who underwent combined stereo-electroencephalography/polysomnography during presurgical evaluation. Epileptic spikes were detected automatically. Spike and burst indices (n/sec/channel) were computed across four 3-second time windows (baseline sleep, pre-arousal, arousal, and post-arousal). Sleep stage and anatomic localization were tested as modulating factors. We assessed the intra-arousal dynamics of spikes and their relationship with the slow wave component of non-rapid eye-movement sleep (NR) arousals. Results: The vast majority of sleep-related seizures (82.4%; 76.5% asymptomatic) were followed by awakenings or arousals. The epileptic burst index increased significantly before arousals as compared to baseline and postarousal, irrespective of sleep stage or brain area. A similar pre-arousal increase was observed for the spike index in NR stage 2 and rapid eye-movement sleep. In addition, the spike index increased during the arousal itself in neocortical channels, and was strongly correlated with the slow wave component of NR arousals (r = 0.99, p < 0.0001). Interpretation: Sleep fragmentation in focal drug-resistant epilepsy is associated with ictal and interictal epileptic activity. The increase in interictal epileptic activity before arousals suggests its participation in sleep disruption. An additional increase in the spike rate during arousals may result from a sleep-wake boundary instability, suggesting a bidirectional relationship.

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“…Learning is one cognitive issue or a consequence and learning problems that lead to an major obstacle to get educational and professional success (66); Psychiatric comorbidities refer to behavior and mood problems, such as bipolar disorder, attention deficit hyperactivity disorder (ADHD), depression, anxiety disorders and autism (66). Neurological comorbidities are migraine headache (69), sleep disorders, such as sleep apnea, insomnia, restless legs syndrome, and the parasomnias (70), pain (neuropathic pain, fibromyalgia, chronic pain) and other (asthma, diabetes, and high blood pressure) (71). The comorbidities are frequent seen in patients with epilepsy, and can deteriorate quality of life further than seizures themselves do (18).…”

Section: Comorbidities Associated With Epilepsymentioning

confidence: 99%

“…Sleep disorders is the common neurologic comorbidities associated with epilepsy (70). Extensive studies have demonstrated that adenosine plays a crucial role in modulation of sleep homeostasis (90, 102, 103).…”

Section: Adenosine Dysfunction In Comorbidities Associated With Epilepsymentioning

confidence: 99%

Role of DNA Methylation and Adenosine in Ketogenic Diet for Pharmacoresistant Epilepsy: Focus on Epileptogenesis and Associated Comorbidities

Fan

Luan

et al. 2019

Front. Neurol.

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Epilepsy is a neurological disorder characterized by a long term propensity to produce unprovoked seizures and by the associated comorbidities including neurological, cognitive, psychiatric, and impairment the quality of life. Despite the clinic availability of several novel antiepileptic drugs (AEDs) with different mechanisms of action, more than one-third of patients with epilepsy suffer with pharmacoresistant epilepsy. Until now, no AEDs have been proven to confer the efficacy in alteration of disease progression or inhibition of the development of epilepsy. The ketogenic diet, the high-fat, low-carbohydrate composition is an alternative metabolic therapy for epilepsy, especially for children with drug-resistant epilepsy. Recently clinical and experimental results demonstrate its efficacy in ameliorating both seizures and comorbidities associated with epilepsy, such as cognitive/psychiatric concerns for the patients with refractory epilepsy. Of importance, ketogenic diet demonstrates to be a promising disease-modifying or partial antiepileptogenesis therapy for epilepsy. The mechanisms of action of ketogenic diet in epilepsy have been revealed recently, such as epigenetic mechanism for increase the adenosine level in the brain and inhibition of DNA methylation. In the present review, we will focus on the mechanisms of ketogenic diet therapies underlying adenosine system in the prevention of epileptogenesis and disease modification. In addition, we will review the role of ketogenic diet therapy in comorbidities associated epilepsy and the underlying mechanisms of adenosine.

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Co-morbid sleep disorders and epilepsy: A narrative review and case examples

Cited by 31 publications

References 87 publications

Gender Differences in Associated and Predictive Factors of Anxiety and Depression in People With Epilepsy

Gender Differences in Associated and Predictive Factors of Anxiety and Depression in People With Epilepsy

Sleep Disruption in Epilepsy: Ictal and Interictal Epileptic Activity Matter

Role of DNA Methylation and Adenosine in Ketogenic Diet for Pharmacoresistant Epilepsy: Focus on Epileptogenesis and Associated Comorbidities

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