Insomnia in epilepsy is associated with continuing seizures and worse quality of life

Quigg, Mark; Gharai, Sean; Ruland, Jeff; Schroeder, Catherine; Hodges, Matthew; Ingersoll, Karen S.; Thorndike, Frances P.; Gao, Yan; Ritterband, Lee M.

doi:10.1016/j.eplepsyres.2016.02.014

Cited by 84 publications

(60 citation statements)

References 22 publications

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“…These include endocrine disturbances such as high serum concentrations of cortisol as a result of a hyperactive hypothalamic–pituitary–adrenal axis, inflammatory mechanisms including the effects of the interleukin (IL)‐1β in the rat hippocampus, and disorders of neurotransmitters such as dopamine, serotonin, norepinephrine, glutamate, and γ‐aminobutyric acid (GABA) . Besides the endocrine, inflammatory, and neurotransmitter disturbances, one additional hypothesis for the association between combined MD and AD and increased risk of pharmacoresistance, is that compared to isolated MD or AD, patients with combined symptoms are more likely to present higher levels of stress, insomnia, and worse sleep quality, which are factors related to increased seizure frequency . One study evaluated the impact of stress on the seizure occurrence and found that sleep deprivation, higher self‐reported stress, and anxiety levels were associated with the seizures.…”

Section: Discussionmentioning

confidence: 99%

“…30 Besides the endocrine, inflammatory, and neurotransmitter disturbances, one additional hypothesis for the association between combined MD and AD and increased risk of pharmacoresistance, is that compared to isolated MD or AD, patients with combined symptoms are more likely to present higher levels of stress, insomnia, and worse sleep quality, which are factors related to increased seizure frequency. [33][34][35] One study 36 evaluated the impact of stress on the seizure occurrence and found that sleep deprivation, higher self-reported stress, and anxiety levels were associated with the seizures. Median of scores on BDI and BAI according to pharmacoresistance.…”

Section: Discussionmentioning

confidence: 99%

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Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

et al. 2017

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Summary Objective To investigate whether mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE). We compared patients without any current psychiatric disorder, patients with current MD and/or AD, patients with subsyndromic depression episodes (SSDE) and anxiety episodes (SSAE), and patients with family psychiatric history. Methods In a cross‐sectional study, we included 144 consecutive patients with MTLE (82 pharmacoresistant and 62 treatment‐responsive patients). Every patient underwent a psychiatric evaluation including the Structured Clinical Interview for DSM‐IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis I (SCID‐I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neurological Disorders Depression Inventory for Epilepsy (NDDI‐E), and Interictal Dysphoric Disorder Inventory (IDDI). Patients were divided into four groups: PsychNeg (G1, n = 61), current SSDE and SSAE (G2, n = 26), Current MD or AD (G3, n = 25), and current mixed MD/AD (G4, n = 32). Results Among patients with pharmacoresistant MTLE, 68.3% (56/82) experienced symptoms of depression and/or anxiety (G2, G3, and G4) (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.41–5.53, p < 0.01). Patients with mixed MD/AD (G4, n = 24/32) were more likely to have pharmacoresistant MTLE (OR 4.04, 95% CI 1.57–10.42, p < 0.01) than psychiatric asymptomatic patients (G1, n = 26/61), and their seizure frequency was significantly higher (p < 0.01). Positive family psychiatric history was more frequent in pharmacoresistant patients (n = 27/82, OR 2.28, 95% CI 1.02–5.05, p = 0.04). Finally, 31.6% of patients with MD and or AD were not receiving psychiatric treatment. Significance Identification of comorbid MD/AD and of family psychiatric history is of the essence in patients with MTLE, as they appear to be associated with worse seizure control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

et al. 2017

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“…Further knowledge about the exact impact of seizures on circadian rhythmicity is of particular interest for several reasons. On one hand, alterations in diurnal rhythms can contribute to the burden of epilepsy affecting quality of life in patients [20,21]. In addition, respective alterations should be considered for disease management including therapy and patient counselling [16].…”

Section: Introductionmentioning

confidence: 99%

Impact of repeated kindled seizures on heart rate rhythms, heart rate variability, and locomotor activity in rats

Möller

Dijk

Wolf

et al. 2019

Epilepsy & Behavior

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Although an impact of epilepsy on circadian rhythmicity is well-recognized, there are profound gaps in our understanding of the influence of seizures on diurnal rhythms. The effect on activity levels and heart rate is of particular interest as it might contribute to the disease burden. The kindling model with telemetric transmitter implants provides excellent opportunities to study the consequences of focal and generalized seizures under standardized conditions. Data from kindled rats with generalized seizures revealed an increase in activity and heart rate during the resting phase. Total and short-term heart rate variabilities were not affected by electrode implantation or seizure induction. Ictal alterations in heart rate associated with generalized seizures were characterized by a biphasic bradycardia with an immediate drop of heart rate followed by a transient normalization and a second more steady decrease. In conclusion, the findings demonstrate that once daily generalized seizures can exert significant effects on heart rate rhythms. Respective alterations in patients would be of relevance for patient counselling and therapeutic management. Occurrence of biphasic bradycardia associated with seizure induction suggests that the kindling model is suitable to study the consequences and the prevention of ictal bradycardia, which may pose patients at risk for sudden unexpected death.

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“…[4,5], при этом их частота значительно превышает общепопуляционную, составляя от 24 до 55%. Среди сопутствующих эпилепсии заболеваний следует выделить бессонницу -вследствие ее высокой частоты, а также неблагоприятного влияния на контроль эпилептических приступов и качество жизни [6]. В.А.…”

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The relationship of sleep mechanisms and epileptogenesis

2020

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Close links between epilepsy and sleep is doubtless; however, the available literature does not allow for its unequivocal interpretation from the common pathophysiological mechanisms' perspective. GABAergic neuronal deficiency is believed to be the neurochemical background of the intimate mechanisms of sleep and epileptogenesis. Sleep impacts the epileptiform activity, with an increase in epileptiform discharge during NREM and a decrease during REM phases. Sleep deprivation may complicate the course of epilepsy, while epileptic attacks may change the sleep structure and quality. Anti-epileptic agents exert diverse effects on the sleep architectonics; they can induce sedation or increase alertness. Our potential to correct the results of the pathological interplay between sleep mechanisms and epilepsy are rather limited and are frequently overestimated by clinicians. Investigation of the interrelationship between epileptic seizures and sleep and the use of polysomnography can substantially add to the diagnosis of the epileptic syndrome and define the subsequent outcomes.

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Insomnia in epilepsy is associated with continuing seizures and worse quality of life

Cited by 84 publications

References 22 publications

Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

Impact of repeated kindled seizures on heart rate rhythms, heart rate variability, and locomotor activity in rats

The relationship of sleep mechanisms and epileptogenesis

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