Severity of self-reported insomnia in adults with epilepsy is related to comorbid medical disorders and depressive symptoms

Yang, Kwang Ik; Grigg-Damberger, Madeleine; Andrews, Noah; O’Rourke, Colin; Bena, James; Foldvary‐Schaefer, Nancy

doi:10.1016/j.yebeh.2016.03.023

Cited by 28 publications

(16 citation statements)

References 35 publications

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“…Owing to the lack of a predefined MCID for AM stiffness in the literature, the minimum important difference (MID) was defined as a reduction of ≥ 1 point for severity and one half standard deviation of the mean baseline values for duration of AM stiffness [8, 30, 31]. Normative values for PROs were obtained from the literature and defined as the following: ≤ 20 for PtGA [37], 0.25 for HAQ-DI [38], 50 for SF-36 PCS and MCS [39], 0–7 for ISI [33], and 0.915 for EQ-5D-5L [40]. Normative values are not available for pain VAS or AM stiffness [8, 30, 31, 41].…”

Section: Methodsmentioning

confidence: 99%

Effects of upadacitinib on patient-reported outcomes: results from SELECT-BEYOND, a phase 3 randomized trial in patients with rheumatoid arthritis and inadequate responses to biologic disease-modifying antirheumatic drugs

et al. 2019

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BackgroundPatient-reported outcomes (PROs) are important when evaluating treatment benefits in rheumatoid arthritis (RA). We compared upadacitinib, an oral, selective JAK-1 inhibitor, with placebo to assess clinically meaningful improvements in PROs in patients with RA who have had inadequate responses to biologic disease-modifying antirheumatic drugs (bDMARD-IR).MethodsPRO responses between upadacitinib 15 mg or 30 mg and placebo were evaluated at week 12 from the SELECT-BEYOND trial. Improvement was determined by measuring Patient Global Assessment of Disease Activity (PtGA), pain, Health Assessment Questionnaire Disability Index (HAQ-DI), Short Form-36 Health Survey (SF-36), duration and severity of morning (AM) stiffness, and Insomnia Severity Index (ISI). Least squares mean changes and percentage of patients reporting improvements ≥ minimum clinically important differences (MCID) and scores greater than or equal to normative values were determined. The number needed to treat (NNT) to achieve clinically meaningful improvements was calculated.ResultsIn 498 patients, both upadacitinib doses resulted in statistically significant changes from baseline versus placebo in PtGA, pain, HAQ-DI, SF-36 Physical Component Summary (PCS), 7 of 8 SF-36 domains (15 mg), 6 of 8 SF-36 domains (30 mg), and AM stiffness duration and severity. Compared with placebo, more upadacitinib-treated patients reported improvements ≥ MCID in PtGA, pain, HAQ-DI, SF-36 PCS, 7 of 8 SF-36 domains (15 mg), 5 of 8 SF-36 domains (30 mg), AM stiffness duration and severity, and ISI (30 mg) and scores ≥ normative values in HAQ-DI and SF-36 domains. Across most PROs, NNTs to achieve MCID with upadacitinib ranged from 4 to 7 patients.ConclusionsIn bDMARD-IR RA patients, upadacitinib (15 mg or 30 mg) improved multiple aspects of quality of life, and more patients reached clinically meaningful improvements approaching normative values compared with placebo.Trial registrationThe trial is registered with ClinicalTrials.gov (NCT02706847), registered 6 March 2016.

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Section: Methodsmentioning

confidence: 99%

Effects of upadacitinib on patient-reported outcomes: results from SELECT-BEYOND, a phase 3 randomized trial in patients with rheumatoid arthritis and inadequate responses to biologic disease-modifying antirheumatic drugs

et al. 2019

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“…In a prospective longitudinal study comprising 95 patients with unclassified epilepsies, 65,5% suffered from mild to moderate, and 28,9% from severe insomnia. Among the predictors for severe insomnia were a history of prior head trauma, previous epilepsy surgery, intake of sedative drugs, and antiepileptic polypharmacotherapy [67].…”

Section: Insomnia In Epilepsymentioning

confidence: 99%

Insomnia in neurological diseases

Mayer

Happe²,

Evers

et al. 2021

Neurol. Res. Pract.

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Insomnia is defined as difficulties of initiating and maintaining sleep, early awakening and poor subjective sleep quality despite adequate opportunity and circumstances for sleep with impairment of daytime performance. These components of insomnia – namely persistent sleep difficulties despite of adequate sleep opportunity resulting in daytime dysfunction - appear secondary or co-morbid to neurological diseases. Comorbid insomnia originates from neurodegenerative, inflammatory, traumatic or ischemic changes in sleep regulating brainstem and hypothalamic nuclei with consecutive changes of neurotransmitters. Symptoms of neurological disorders (i.e motor deficits), co-morbidities (i.e. pain, depression, anxiety) and some disease-specific pharmaceuticals may cause insomnia and/or other sleep problems.This guideline focuses on insomnias in headaches, neurodegenerative movement disorders, multiple sclerosis, traumatic brain injury, epilepsies, stroke, neuromuscular disease and dementia.The most important new recommendations are: Cognitive behavioral therapy (CBTi) is recommended to treat acute and chronic insomnia in headache patients. Insomnia is one of the most frequent sleep complaints in neurodegenerative movement disorders. Patients may benefit from CBTi, antidepressants (trazodone, doxepin), melatonin and gaba-agonists. Insomnia is a frequent precursor of MS symptoms by up to 10 years. CBTi is recommended in patients with MS, traumatic brain injury and. Melatonin may improve insomnia symptoms in children with epilepsies. Patients with insomnia after stroke can be treated with benzodiazepine receptor agonists and sedating antidepressants. For patients with dementia suffering from insomnia trazodone, light therapy and physical exercise are recommended.

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“…al. [57], where the strength of the correlation between insomnia and epilepsy was checked, taking into account depression as a comorbid disease. Whereas Scarlatelli-Lima et.…”

Section: Memorymentioning

confidence: 99%

Bilateral dependence of sleep disorders and temporal lobe epilepsy – literature review

Drabik¹,

Sarnacki²,

Miziak³

2021

Med Og Nauk Zdr.

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Introduction. The analysis of sleep and its phases in the context of various pathophysiologies has attracted increasing attention from the scientific community; therfore, this review of the literature focuses on temporal lobe epilepsy (TLE). Objective. The aim of the review is to systematize and update the knowledge and research currently available on the interplay of sleep deprivation and seizures in TLE, with a focus on MTLE. Materials and method. The following keyword combinations were used to search the Pubmed, Science Direct and Google Scholar databases: sleep disturbance in mesial temporal lobe epilepsy, sleep in temporal lobe epilepsy, nocturnal temporal lobe epilepsy, temporal epilepsy sleep disturbance. After applying exclusion criteria, 23 papers were selected for the review. Brief description of the state of knowledge. The publications qualified for the review were divided into 7 categories in terms of the subject of the publication. These categories relate to characteristic brain waves, memory and its consolidation processes, heart and sleep apnea, anti-epileptic drugs, motor disorders and lateralization of the discharges. Articles that did not fit into any of the previously mentioned categories were placed in the 'Other' group. Conclusions. It is agreed that sleep is an important factor that should be taken into account when selecting the appropriate treatment and researching new AEDs. Moreover, sleep is significant to the patient›s quality of life, has a profound impact on its components, for example, physical and social functions, emotions and leisure, but may also influence the effectiveness of therapy.

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Severity of self-reported insomnia in adults with epilepsy is related to comorbid medical disorders and depressive symptoms

Cited by 28 publications

References 35 publications

Effects of upadacitinib on patient-reported outcomes: results from SELECT-BEYOND, a phase 3 randomized trial in patients with rheumatoid arthritis and inadequate responses to biologic disease-modifying antirheumatic drugs

Effects of upadacitinib on patient-reported outcomes: results from SELECT-BEYOND, a phase 3 randomized trial in patients with rheumatoid arthritis and inadequate responses to biologic disease-modifying antirheumatic drugs

Insomnia in neurological diseases

Bilateral dependence of sleep disorders and temporal lobe epilepsy – literature review

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