Rapid eye movement (REM) sleep and seizure control in idiopathic generalized epilepsy

Epilepsy Behav. 2020 Jun:107:107064. doi: 10.1016/j.yebeh.2020.107064. Epub 2020 Apr 19.

Abstract

Background: Sleep and epilepsy are bedfellows, and they affect each other reciprocally. Despite the well-known relationship between sleep and epilepsy, data about the impact of sleep on seizure control and responsiveness to therapy are scarce.

Objective: The aim of this work was to study the impact of sleep architecture in drug-naïve patients with idiopathic generalized epilepsy (IGE) on seizure control and responsiveness to treatment.

Methods: This is a prospective cohort study conducted on thirty newly diagnosed patients with IGE attending the epilepsy clinic in Alexandria University Hospital in Egypt and thirty healthy controls. All recruited subjects had a baseline overnight polysomnographic study, then patients were given sodium valproate in therapeutic doses and followed up for six months for assessment of seizure control. After follow-up, they were classified into fully controlled and inadequately controlled patients, and a comparison between them was made.

Results: Of the recruited patients, 13 were fully controlled. Rapid eye movement (REM) sleep % was significantly lower among inadequately controlled patients (9.01 ± 6.23) than fully controlled group (19.6 ± 9.01) and controls (18.17 ± 4.85) (p = 0.002), and the REM sleep latency was significantly longer among the inadequately controlled patients (115.7 ± 72.8 min) than fully controlled patients (54.6 ± 77.3 min) and controls (68.75 ± 37.95 min) (p = 011). On univariate regression analysis, the Odd's ratio (OR) for REM sleep percentage was 3.04 (p = 0.001).

Conclusion: Rapid eye movement sleep percentage and latency can contribute to seizure control in IGE.

Keywords: Epilepsy; Idiopathic generalized epilepsy; REM latency; REM sleep; Seizure control; Sleep.

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / pharmacology
  • Anticonvulsants / therapeutic use*
  • Child
  • Cohort Studies
  • Egypt / epidemiology
  • Epilepsy, Generalized / drug therapy*
  • Epilepsy, Generalized / epidemiology
  • Epilepsy, Generalized / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Prospective Studies
  • Seizures / drug therapy*
  • Seizures / epidemiology
  • Seizures / physiopathology*
  • Sleep, REM / drug effects
  • Sleep, REM / physiology*
  • Valproic Acid / pharmacology
  • Valproic Acid / therapeutic use
  • Young Adult

Substances

  • Anticonvulsants
  • Valproic Acid

Supplementary concepts

  • Epilepsy, Idiopathic Generalized