Markedly disturbed sleep in medically refractory compared to controlled epilepsy – A clinical and polysomnography study
Paresh Zanzmera,Garima Shukla,Anupama Gupta,Hariom Singh,Vinay Goyal,Achal Kumar Srivastava,Madhuri Behari +6 more
TLDR
The results indicate that medically refractory epilepsy patients believe that they spend more time sleeping, in contrast to the documented shorter sleep duration on polysomnography.Abstract:
Purpose To evaluate sleep disturbances or sleep related events and their characteristics among patients with medically refractory epilepsy, compared to those with controlled epilepsy. Methods In a prospective case-controlled study, patients of medically refractory and controlled epilepsy were recruited and history pertaining to epilepsy and sleep related events and Epworth sleepiness scores were recorded and all patients underwent over night polysomnography. Results Among 40 patients, 20 with medically refractory (Group 1) and 20 with controlled epilepsy (Group 2) (median age 18, range 10–35 years), the self reported sleep parameters in Group 1 patients were found to be significantly different as compared to Group 2, in terms of the duration of night time sleep, day time sleep, day time nap frequency, total sleep hours per day, excessive daytime sleepiness (EDS)(45% vs. 15%) and average sleep hours over the week prior to polysomnography. On PSG, Group 1 patients showed significantly less total sleep time [340.4min (147–673) vs. 450.3min (330–570)] with delayed sleep latency and REM latency, poor sleep efficiency [80.45 (40.5–98.0) vs. 95.45 (88.4–99.7)] and frequent arousals and wake after sleep onset (WASO) compared to Group 2 patients. Four patients (20%) in Group 1 compared to none in Group 2 were found to have mild obstructive sleep apnea. Conclusions Our results indicate that medically refractory epilepsy patients believe that they spend more time sleeping, in contrast to the documented shorter sleep duration on polysomnography. This difference between perceived and actual sleep seems, by their data, to arise mainly from sleep fragmentation, disturbed architecture and the interesting finding of associated sleep apnea among the medically refractory epilepsy patients.read more
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Sleep and epilepsy
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Impaired vigilance networks in temporal lobe epilepsy: Mechanisms and clinical implications.
TL;DR: It is proposed that subcortical activating networks underlying vigilance play a critical role in mediating the widespread neural and cognitive effects of focal mTLE.
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Effect of successful epilepsy surgery on subjective and objective sleep parameters – a prospective study
Paresh Zanzmera,Garima Shukla,Anupama Gupta,Vinay Goyal,Achal Kumar Srivastava,Ajay Garg,Chandrashekhar Bal,Ashish Suri,Madhuri Behari +8 more
TL;DR: Epilepsy surgery improves subjective sleep parameters in patients with medically refractory epilepsy during the early post operative period and may improve objective (PSG documented) sleep quality, sleep architecture and obstructive sleep apnea with resultant reduction in excessive daytime sleepiness.
References
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Journal ArticleDOI
Obstructive sleep apnea is common in medically refractory epilepsy patients
TL;DR: In this sample, previously undiagnosed obstructive sleep apnea was common, especially among men, older subjects, and those with seizures during sleep, and the impact of treating OSA on seizure frequency and daytime sleepiness in medically refractory epilepsy patients warrants further controlled study.
Journal ArticleDOI
Cardiorespiratory sleep studies in children: Establishment of normative data and polysomnographic predictors of morbidity
Carole L. Marcus,R. D. Annett,L. J. Brooks,R. T. Brouillette,John L. Carroll,D. C. Givan,D. Gozal,James P. Kiley,Susan Redline,Carol L. Rosen,G. Rosen,David E. Tunkel +11 more
Journal ArticleDOI
Sleep and epilepsy
TL;DR: The reciprocal interaction between sleep and epilepsy is considered, particularly the distinction of nocturnal frontal lobe epilepsy (NFLE) from arousal parasomnias, and the effect of OSA on quality of life is explored.