Effects of epilepsy treatments on sleep architecture and daytime sleepiness: An evidence‐based review of objective sleep metrics

Summary Objective Sleep is considered restorative, and good quantity and quality sleep is required for memory consolidation and synaptic plasticity. Sleep disorders are common in patients with epilepsy. Poor sleep quality or quantity may worsen seizure control. On the other end, seizures and epileps...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) Vol. 55; no. 1; pp. 26 - 37
Main Authors: Jain, Sejal V., Glauser, Tracy A.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01.01.2014
Subjects:
Anticonvulsants - adverse effects
Anticonvulsants - therapeutic use
Antiepileptic agents
Clobazam
Convulsions & seizures
Drug dosages
Epilepsy
Epilepsy - complications
Epilepsy - drug therapy
Epilepsy surgery
Ethosuximide
Humans
Ketogenic diet
Lamotrigine
Phenytoin
Quality
Sleep - drug effects
Sleep - physiology
Sleep disorders
Sleep Wake Disorders - chemically induced
Sleep Wake Disorders - complications
Sleep Wake Disorders - physiopathology
Studies
Topiramate
Vagus nerve stimulator
Vigabatrin
Topiramate
Vagus nerve stimulator
Ethosuximide
Vigabatrin
Epilepsy surgery
Clobazam
Ketogenic diet
Phenytoin
Lamotrigine
ISSN:0013-9580, 1528-1167, 1528-1167
Online Access:Get full text
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Summary:Summary Objective Sleep is considered restorative, and good quantity and quality sleep is required for memory consolidation and synaptic plasticity. Sleep disorders are common in patients with epilepsy. Poor sleep quality or quantity may worsen seizure control. On the other end, seizures and epilepsy may worsen the sleep quality and set a vicious cycle. In addition, antiepileptic drugs have an effect on sleep architecture. We performed a systemic literature review with a goal to evaluate the effect of antiepileptic drugs and nondrug treatments for epilepsy on sleep architecture to help better understand treatment effects, especially in patients with epilepsy and sleep problems. Methods We searched PubMed and identified studies that evaluated objective sleep outcomes for an antiepileptic drug. We also searched for studies with objective sleep outcomes that evaluated other epilepsy treatments such as epilepsy surgery, vagus nerve stimulation, and ketogenic diet. Results The studies were categorized based on evidence class and study population for an individual antiepileptic drug or treatment. We identified that most antiepileptic drugs and nondrug treatments for epilepsy affect sleep architecture. Significance We identified that gabapentin, tiagabine, pregabalin, clobazam, and carbamazepine reduce sleep latency and/or improve sleep efficiency. Phenobarbital, valproic acid, and higher‐dose levetiracetam aggravate daytime sleepiness, whereas topiramate and zonisamide do not. Vagus nerve stimulation reduces daytime sleepiness, and ketogenic diet improves slow‐wave sleep. Epilepsy surgery may improve nocturnal sleep only in a subgroup of patients with improved seizure frequency. Further studies are needed to evaluate the dose‐dependent sleep effects of antiepileptic drugs and nondrug treatments independent of the improvement of epilepsy, and to identify if these changes are clinically significant.
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ISSN:0013-9580
1528-1167
1528-1167
DOI:10.1111/epi.12478