The Interaction Between Sleep and Epilepsy

Roliz, Annie; Kothare, Sanjeev V.

doi:10.1007/s11910-022-01219-1

Cited by 21 publications

(18 citation statements)

References 143 publications

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“…Our results, besides supporting previous findings, underline that sleep impairment in PWE is not only an effect of ASMs 37 or of recent epileptic seizures, but is possibly related to the sleep networks dysregulation 38 . Hence, it is crucial to target sleep impairment, namely, sleep fragmentation, since improving sleep quality may protect against epileptic seizures, reduce the risk of sudden unexpected death, and possibly reduce the burden of comorbidities, such as cognitive deterioration, depression, and anxiety 39,40 …”

Section: Discussionsupporting

confidence: 87%

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Sleep architecture in drug‐naïve adult patients with epilepsy: Comparison between focal and generalized epilepsy

et al. 2023

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Objective: Sleep impairment is one of the most common comorbidities affecting people with epilepsy (PWE). The bidirectional relation between epilepsy and sleep has been widely established. Several studies investigated subjective sleep quality and daytime vigilance in PWE, highlighting frequent complaints of sleep fragmentation, difficulties in falling asleep, and daytime sleepiness. The present study aimed to evaluate sleep structure in drug-naive PWE, distributed on the basis of epilepsy type, and compared with controls. Methods: This observational study included adult patients newly diagnosed with epilepsy and drug-naive as well as a control group of healthy subjects. All PWE and controls underwent a dynamic 24-h EEG with signals for sleep recording to evaluate sleep architecture, structure, continuity, and fragmentation.Results: Twenty-four PWE were included and distributed in two groups based on epilepsy type. Eleven patients were included in the generalized epilepsy group (63.6% male; 34.91 ± 9.80 years) and 13 patients in the focal epilepsy group (53.8% male; 38.69 ± 12.74 years). The control group included 16 subjects (56.3% male; 32.75 ± 12.19 years). Patients with generalized or focal epilepsy had a significantly lower sleep efficiency than controls. Moreover, both patient groups presented the alteration of markers of sleep fragmentation and loss of continuity, with higher indices of sleep stage transitions and arousal. Finally, the two patient groups presented less REM sleep than controls.

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Section: Discussionsupporting

confidence: 87%

“… 38 Hence, it is crucial to target sleep impairment, namely, sleep fragmentation, since improving sleep quality may protect against epileptic seizures, reduce the risk of sudden unexpected death, and possibly reduce the burden of comorbidities, such as cognitive deterioration, depression, and anxiety. 39 , 40 …”

Section: Discussionmentioning

confidence: 99%

Sleep architecture in drug‐naïve adult patients with epilepsy: Comparison between focal and generalized epilepsy

et al. 2023

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“…Preserving good sleep quality and adequate sleep architecture is very important also in patients with epilepsy, 120 as this may ensure a good control of epileptic seizures as well. Thus, the use of drugs such as orexin receptor antagonists can be helpful in these patients, also considering the role of orexins in the control of REM sleep, which is relevant to patients with epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, epilepsy is associated with cyclic patterns, which has led to new treatment approaches, including orexin receptor antagonists. 120 Specifically, the loss of orexinergic activity has been associated with REM sleep onset, 29 , 32 and REM sleep is generally protective against seizures. As such, a dynamic modulation of seizure threshold by orexin (through a so-called “orexi-cortical axis”) has been postulated, in which orexinergic activity regulates sleep-wake states to modify ascending subcortical influences on cortical synchronization, with subsequent effects on seizure threshold.…”

Section: The Role Of Orexins In Diseasementioning

confidence: 99%

Targeting Orexin Receptors for the Treatment of Insomnia: From Physiological Mechanisms to Current Clinical Evidence and Recommendations

Mogavero

Silvani

Lanza

et al. 2023

NSS

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After a detailed description of orexins and their roles in sleep and other medical disorders, we discuss here the current clinical evidence on the effects of dual (DORAs) or selective (SORAs) orexin receptor antagonists on insomnia with the aim to provide recommendations for their further assessment in a context of personalized and precision medicine. In the last decade, many trials have been conducted with orexin receptor antagonists, which represent an innovative and valid therapeutic option based on the multiple mechanisms of action of orexins on different biological circuits, both centrally and peripherally, and their role in a wide range of medical conditions which are often associated with insomnia. A very interesting aspect of this new category of drugs is that they have limited abuse liability and their discontinuation does not seem associated with significant rebound effects. Further studies on the efficacy of DORAs are required, especially on children and adolescents and in particular conditions, such as menopause. Which DORA is most suitable for each patient, based on comorbidities and/or concomitant treatments, should be the focus of further careful research. On the contrary, studies on SORAs, some of which seem to be appropriate also in insomnia in patients with psychiatric diseases, are still at an early stage and, therefore, do not allow to draw definite conclusions.

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“…It is currently widely believed that the primary function of the Orexin system is to regulate the sleep-wake state. There are presently more comprehensive reviews and studies available [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

the inhibitory effect of Orexin system on different diseases through mTOR signaling pathway

song

wang

et al. 2022

Preprint

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Orexins, also known as hypocretins, are two neuropeptides secreted from orexin-containing neurons, mainly in the lateral hypothalamus (LH). The mTOR pathway is an essential component of the Orexin/GPCR downstream signaling network and can be activated and activated by Orexin. This review article summarizes the Orexin system and its inhibition of various diseases through mTOR signaling pathway. In addition, the potential of targeting the Orexin system for treating a wide range of conditions is discussed.

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The Interaction Between Sleep and Epilepsy

Cited by 21 publications

References 143 publications

Sleep architecture in drug‐naïve adult patients with epilepsy: Comparison between focal and generalized epilepsy

Sleep architecture in drug‐naïve adult patients with epilepsy: Comparison between focal and generalized epilepsy

Targeting Orexin Receptors for the Treatment of Insomnia: From Physiological Mechanisms to Current Clinical Evidence and Recommendations

the inhibitory effect of Orexin system on different diseases through mTOR signaling pathway

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