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Sleep, sleep apnea, and epilepsy

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Opinion statement

Sleep disorders occur commonly in patients with epilepsy, and can be responsible for symptoms of daytime somnolence and also can contribute to the intractability of epilepsy. The most important aspect of treating sleep disorders, especially sleep apnea, is the recognition of the problem. In a busy clinical practice, symptoms of sleep disorders are frequently overlooked or mistaken. Whenever sleep disruption or excessive daytime somnolence is potentially problematic, the patient should be referred to a sleep specialist and, if indicated, diagnostic testing performed (usually polysomnography with or without multiple sleep latency tests). The author also recommends that all patients receive basic counseling about sleep hygiene, because its principles are often helpful to patients in general. Even in the absence of a sleep disorder, the choice of an anticonvulsant can be partly tailored to the sleep needs of the patient, with alerting drugs (lamotrigine and felbamate) dosed early in the day and relatively sedating agents (phenobarbital and phenytoin) dosed later or at bedtime.

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References and Recommended Reading

  1. Bazil CW, Castro LHM, Walczak TS: Reduction of rapid eye movement sleep by diurnal and nocturnal seizures in temporal lobe epilepsy. Arch Neurol 2000, 57:363–368.

    Article  PubMed  CAS  Google Scholar 

  2. Walters AS, Hening WA, Kavey N, et al.: A double-blind, randomized crossover trial of bromocriptine and placebo in the restless legs syndrome. Ann Neurol 1988, 24:455.

    Article  PubMed  CAS  Google Scholar 

  3. Earley CJ, Allen RP: Pergolide and carbidopa/levodopa treatment of the restless legs syndrome and periodic leg movements in sleep in a consecutive series of patients. Sleep 1996, 19:801.

    PubMed  CAS  Google Scholar 

  4. Lin SC, Kaplan J, Burger CD, Frederickson PA: Effect of pramiprexole in threatment of resistant restless legs syndrome. Mayo Clin Proc 1998, 73:497.

    PubMed  CAS  Google Scholar 

  5. Garcia-Borreguero D, Larrosa O, de la Llave Y, et al.: Treatment of restless legs syndrome with gabapentin: a double-blind, crossover study. Neurology 2002, 59:1573–1579. This article is of importance because it shows a definite effect of an antiepileptic drug on a sleep disorder—in this case RLS.

    PubMed  CAS  Google Scholar 

  6. Telstad W, Sorensen O, Larsen S, et al.: Treatment of the restless legs syndrome with carbamazepine: a doubleblind study. BMJ 1984, 288:444.

    Article  PubMed  CAS  Google Scholar 

  7. Robinson A, Guilleminault C: Narcolepsy. In Sleep Disorders Medicine, edn 2. Edited by Chokroverty S. Boston: Butterworth-Heinemann; 1999:427–440.

    Google Scholar 

  8. Scrima L, Hartman PG, Johnson FH Jr., Hiller FC: Efficacy of gamma-hydroxybutyrate versus placebo in treating narcolepsy-cataplexy: double-blind subjective measures. Biol Psychiatry 1989, 26:331–343.

    Article  PubMed  CAS  Google Scholar 

  9. Nieves AV, Lang AE: Treatment of excessive daytime sleepiness in patients with Parkinson’s disease with modafinil. Clin Neuropharmacol 2002, 25:111–114. This article suggests that modafinil may have usefulness in drowsiness caused by a number of other medical conditions.

    Article  PubMed  CAS  Google Scholar 

  10. Wolf O, Roder-Wanner UU, Brede M: Influence of therapeutic phenobarbital and phenytoin medication on the polygraphic sleep of patients with epilepsy. Epilepsia 1984, 25:467–475.

    PubMed  CAS  Google Scholar 

  11. Wooten VD, Buysse DJ: Sleep in psychiatric disorders. In Sleep Disorders Medicine, edn 2. Edited by Chokroverty S, Daroff RB. Boston: Butterworth-Heinemann; 1999:573–586.

    Google Scholar 

  12. Wolf P, Roder-Wanner UU, Brede M: Influence of therapeutic phenobarbital and phenytoin medication on the polygraphic sleep of patients with epilepsy. Epilepsia 1984, 25:467–475.

    PubMed  CAS  Google Scholar 

  13. Drake ME, Pakalnis A, Bodner JE, Andrews JM: Outpatient sleep recording during antiepileptic drug monotherapy. Clin Electroencephalogr 1990, 21:170–173.

    PubMed  Google Scholar 

  14. Declerk AC, Wauquier A: Influence of antiepileptic drugs on sleep patterns. In Epilepsy, Sleep, and Sleep Deprivation, edn 2. Edited by Degen R, Rodin EA. Amsterdam: Elsevier; 1991:153–162.

    Google Scholar 

  15. Roder-Wanner UU, Noachtar S, Wolf P: Response of polygraphic sleep to phenytoin treatment for epilepsy: a longitudinal study of immediate, short- and long-term effects. Acta Neurol Scand 1987, 76:157–167.

    PubMed  CAS  Google Scholar 

  16. Legros B, Bazil CW: Effects of antiepileptic drugs on sleep architecture: a pilot study. Sleep Med 2003, 4:51–55.

    Article  PubMed  Google Scholar 

  17. Placidi F, Diomedi M, Scalise A, et al.: Effect of anticonvulsants on nocturnal sleep in epilepsy. Neurology 2000, 54 (suppl):S25-S32.

    PubMed  CAS  Google Scholar 

  18. Yang JD, Elphick M, Sharpley AL, Cowen PJ: Effects of carbamazepine on sleep in healthy volunteers. Biol Psychiatry 1989, 26:324–328.

    Article  PubMed  CAS  Google Scholar 

  19. Foldvary N, Perry M, Lee J, et al.: The effects of lamotrigine on sleep in patients with epilepsy. Epilepsia 2001, 42:1569–1573.

    Article  PubMed  CAS  Google Scholar 

  20. Rao ML, Clarenbach P, Vahlensieck M, Kratzschmar S: Gabapentin augments whole blood serotonin in healthy young men. J Neural Transm 1988, 73:129–134.

    Article  PubMed  CAS  Google Scholar 

  21. Foldvary-Schaefer N, Sanchez IDL, Karafa M, et al.: Gabapentin increases slow wave sleep in normal adults. Epilepsia 2002, 43:1493–1497. The most recent (and most convincing) of several papers demonstrating beneficial effects of an antiepileptic drug on sleep, independent of anticonvulsant effects.

    Article  PubMed  CAS  Google Scholar 

  22. Bell C, Vanderlinden H, Hiersemenzel R, et al.: The effects of levetiracetam on objective and subjective sleep parameters in healthy volunteers and patients with partial epilepsy. J Sleep Med 2002, 11:255–263.

    Article  Google Scholar 

  23. Salinsky MC, Oken BS, Binder LM: Assessment of drowsiness in epilepsy patients receiving chronic antiepileptic drug therapy. Epilepsia 1996, 37:181–187.

    Article  PubMed  CAS  Google Scholar 

  24. Malow BA, Fromes GA, Aldrich MS: Usefulness of polysomnography in epilepsy patients. Neurology 1997, 48:1389–1394.

    PubMed  CAS  Google Scholar 

  25. Riley RW, Powell NB, Guilleminault C: Maxillofacial surgery and nasal CPAP: a comparison of treatment for obstructive sleep apnea syndrome. Chest 1990, 98:1421.

    PubMed  CAS  Google Scholar 

  26. Riley RW, Powell NB, Guilleminault C: Maxillofacial surgery and obstructive sleep apnea: review of 80 patients. Otolaryngol Head Neck Surg 1989, 101:353.

    PubMed  CAS  Google Scholar 

  27. Beran RG, Plunkett MJ, Holland GJ: Interface of epilepsy and sleep disorders. Seizure 1999, 8:97–102.

    Article  PubMed  CAS  Google Scholar 

  28. Devinsky O, Ehrenberg B, Barthlen GM, et al.: Epilepsy and sleep apnea syndrome. Neurology 1994, 44:2060–2064.

    PubMed  CAS  Google Scholar 

  29. Vaughn BV, D’Cruz OF, Beach R, Messenheimer JA: Improvement in epileptic seizure control with treatment of obstructive sleep apnea. Seizure 1996, 5:73–78.

    Article  PubMed  CAS  Google Scholar 

  30. Malow BA, Edwards J, Marzec M, et al.: Effects of vagus nerve simulator on respiration during sleep. Neurology 2000, 55:1450–1454.

    PubMed  CAS  Google Scholar 

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  1. The Neurological Institute, Columbia University, 710 West 168 Street, 10032, New York, NY, USA

    Carl W. Bazil MD, PhD

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  1. Carl W. Bazil MD, PhD
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Bazil, C.W. Sleep, sleep apnea, and epilepsy. Curr Treat Options Neurol 6, 339–345 (2004). https://doi.org/10.1007/s11940-004-0033-4

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  • DOI: https://doi.org/10.1007/s11940-004-0033-4

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