Effects of epilepsy treatment on sleep architecture and daytime sleepiness: An evidence‐based review of objective sleep metrics

Romigi, Andrea; Izzi, Francesca; Mercuri, Nicola Biagio; Albanese, Maria; Liguori, Claudio; Placidi, Fabio

doi:10.1111/epi.12572

Cited by 3 publications

(1 citation statement)

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“…Previous systematic reviews [71,72] and individual studies suggest that some ASMs may induce sleep fragmentation (increase of light sleep and wakefulness after sleep onset, reduction of N3 and REM sleep) [73], while others have a neutral or positive effect on sleep, either directly or indirectly through clinical and electrographic improvement of epilepsy [30,68,[71][72][73][74][75]. Barbiturates and phenytoin appear to have mainly adverse effect on nocturnal sleep and increase daytime somnolence [71,73,[76][77][78][79].…”

Section: Impact Of Epilepsy Treatment On Sleep and Alertnessmentioning

confidence: 99%

Expert Opinion: Managing sleep disturbances in people with epilepsy

Nobili

Beniczky

Eriksson

et al. 2021

Epilepsy & Behavior

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Poor sleep and daytime sleepiness are common in people with epilepsy. Sleep disorders can disrupt seizure control and in turn sleep and vigilance problems can be exacerbated by seizures and by antiepileptic treatments. Nevertheless, these aspects are frequently overlooked in clinical practice and a clear agreement on the evidence-based guidelines for managing common sleep disorders in people with epilepsy is lacking. Recently, recommendations to standardize the diagnostic pathway for evaluating patients with sleep-related epilepsies and comorbid sleep disorders have been presented. To build on these, we adopted the Delphi method to establish a consensus within a group of experts and we provide practical recommendations for identifying and managing poor night-time sleep and daytime sleepiness in people with epilepsy. We recommend that a comprehensive clinical history of sleep habits and sleep hygiene should be always obtained from all people with epilepsy and their bed partners. A psychoeducational approach to inform patients about habits or practices that may negatively influence their sleep or their vigilance levels should be used, and strategies for avoiding these should be applied. In case of a suspected comorbid sleep disorder an appropriate diagnostic investigation should be performed. Moreover, the possible presence of sleep fragmentation induced by sleep-related seizures should be ruled out. Finally, the dose and timing of antiepileptic medications and other co-medications should be optimized to improve nocturnal sleep and avoid daytime sedation.

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