Sleep architecture in patients with Juvenile Myoclonic Epilepsy

Mekky, Jaidaa; Elbhrawy, Sonia; Boraey, Mohamed F.; Omar, Horeya M.

doi:10.1016/j.sleep.2017.02.013

Cited by 27 publications

(18 citation statements)

References 22 publications

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“…Not only do the sleep-wake states modulate seizures' threshold but also epileptic activity of both focal and generalized types impacts sleep. Sleep fragmentation, reduction of various sleep stages, difficulties in sleep initiation, and increased daytime sleepiness are the most common disturbances reported in patients with epilepsy (142)(143)(144)(145)(146)(147). On the other hand, no differences in subjectively assessed sleep parameters between patients with well-controlled epilepsy and healthy population were found as well (148).…”

Section: Sleep-swds Relationshipmentioning

confidence: 97%

Circadian Rhythms and Epilepsy: A Suitable Case for Absence Epilepsy

Smyk

Luijtelaar

2020

Front. Neurol.

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Many physiological processes such as sleep, hormonal secretion, or thermoregulation, are expressed as daily rhythms orchestrated by the circadian timing system. A powerful internal clock mechanism ensures proper synchronization of vital functions within an organism on the one hand, and between the organism and the external environment on the other. Some of the pathological processes developing in the brain and body are subjected to circadian modulation as well. Epilepsy is one of the conditions which symptoms often worsen at a very specific time of a day. Variation in peak occurrence depends on the syndrome and localization of the epileptic focus. Moreover, the timing of some types of seizures is closely related to the sleep-wake cycle, one of the most prominent circadian rhythms. This review focuses on childhood absence epilepsy (CAE), a genetic generalized epilepsy syndrome, in which both, the circadian and sleep influences play a significant role in manifestation of symptoms. Human and animal studies report rhythmical occurrence of spike-wave discharges (SWDs), an EEG hallmark of CAE. The endogenous nature of the SWDs rhythm has been confirmed experimentally in a genetic animal model of the disease, rats of the WAG/Rij strain. Well-known detrimental effects of circadian misalignment were demonstrated to impact the severity of ongoing epileptic activity. SWDs are vigilance-dependent in both humans and animal models, occurring most frequently during passive behavioral states and light slow-wave sleep. The relationship with the sleep-wake cycle seems to be bidirectional, while sleep shapes the rhythm of seizures, epileptic phenotype changes sleep architecture. Circadian factors and the sleep-wake states dependency have a potential as add-ons in seizures' forecasting. Stability of the rhythm of recurrent seizures in individual patients has been already used as a variable which refines existing algorithms for seizures' prediction. On the other hand, apart from successful pharmacological approach, circadian hygiene including sufficient sleep and avoidance of internal desynchronization or sleep loss, may be beneficial for patients with epilepsy in everyday management of seizures.

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Section: Sleep-swds Relationshipmentioning

confidence: 97%

Circadian Rhythms and Epilepsy: A Suitable Case for Absence Epilepsy

Smyk

Luijtelaar

2020

Front. Neurol.

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“…Juvenil myoklonik epilepsisi (JME) olan ve VA kullanan epileptik hastaların uyku yapısını değerlendirmeyi hedefleyen bir çalışmadaki polisomnografik veriler incelendiğinde, kontrol grubuna göre uyku etkinliği azalmış, uykuya geçiş süresi uzamış ve total NREM evresinin azaldığı saptanmıştır. [12] Farklı bir çalışmada ise henüz yeni tanı almış olan JME hastaları, halen VA kullanmakta olan hastalar ve kontrol grubunun uyku yapısı değerlendirilmiştir. Polisomnografik veriler incelendiğinde, epilepsi hasta grubunda uyku etkinliğinin azaldığı, REM başlangıç latansının uzadığı ve REM yüzdesinin kontrol grubuna göre azaldığı, uyku sonrası uyanıklık süresinin arttığı saptanmıştır.…”

Section: Discussionunclassified

“…Ayrıca, VA ile tedavi edilmekte olan grupta henüz yeni tanı alan JME grubundan farklı olarak uyku etkinliğinin ve NREM Evre 2 ve 3 sürelerinin arttığı saptanmıştır. [13] Bizim çalışmamızda, uyku sonrası uyanıklık süresi epilepsi hasta ve kontrol grubu arasında farklılık göstermemekteydi. Epilepsi hasta grubunda NREM Evre 3 yüzdesinde istatistiksel olarak anlamlı derecede artış saptandı (p=0.027).…”

Section: Discussionunclassified

Evaluation of Sleep Structure in Patients with Epilepsy

Sünter¹

2019

Epilepsi

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Objectives: Sleep disorders are more common in patients with epilepsy than in healthy individuals. Epileptic syndromes and antiepileptic drugs can alter the structure of sleep. The aim of this study was to analyze differences in sleep patterns between patients with epilepsy and healthy individuals using subjective tests and polysomnographic evaluation. Methods: The determination of sleep characteristics and the presence of sleep disorders were evaluated using standard questionnaires and polysomnography in 29 patients with epilepsy and 25 controls. The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Insomnia Severity Index (ISI) were administered to assess the participants. Results: The mean PSQI, ESS, and ISI scores in adults with epilepsy were 12.76±8.93, 5.28±3.67, and 7.31±5.39, respectively. Lower sleep efficiency (p=0.046), decreased N1 sleep stage percentage (p=0.001), decreased rapid eye movement sleep stage percentage (p=0.001), and an increased N3 sleep stage percentage (p=0.012) were observed in patients with epilepsy. It was also noted that sleep latency was shorter in patients with epilepsy than in the control group (p=0.027). Conclusion: Sleep architecture has individual variability. Age, comorbidities, medications, and sleep recording methods are some of the factors that contribute to this variability. Both the disease itself and drugs used in the treatment of epilepsy can alter the structure of sleep. Our findings were similar to other studies investigating sleep macrostructure comparing adults with epilepsy and healthy individuals. However, knowledge of how epileptic mechanisms and antiepileptic drugs affect sleep is still insufficient.

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“…It may be the explanation for increased seizure susceptibility in JME patients at this time of the day. In addition, the REM sleeponset latency is prolonged, and the REM percentage is decreased (63). Thus, there are significant alterations in sleep architecture in patients with JME.…”

Section: Sleep-related Epilepsymentioning

confidence: 99%

Epilepsy and Its Interaction With Sleep and Circadian Rhythm

et al. 2020

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Growing evidence shows the bidirectional interactions between sleep, circadian rhythm, and epilepsy. Comprehending how these interact with each other may help to advance our understanding of the pathophysiology of epilepsy and develop new treatment strategies to improve seizure control by reducing the medication side effects and the risks associated with seizures. In this review, we present the overview of different temporal patterns of interictal epileptiform discharges and epileptic seizures over a period of 24 consecutive hours. Furthermore, we discuss the underlying mechanism of the core-clock gene in periodic seizure occurrences. Finally, we outline the role of circadian patterns of seizures on seizure forecasting models and its implication for chronotherapy in epilepsy.

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Sleep architecture in patients with Juvenile Myoclonic Epilepsy

Cited by 27 publications

References 22 publications

Circadian Rhythms and Epilepsy: A Suitable Case for Absence Epilepsy

Circadian Rhythms and Epilepsy: A Suitable Case for Absence Epilepsy

Evaluation of Sleep Structure in Patients with Epilepsy

Epilepsy and Its Interaction With Sleep and Circadian Rhythm

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