Parasomnias, sleep-related movement disorders and physiological sleep variants in focal epilepsy: A polysomnographic study

Abstract

The link existing between epilepsy and sleep is widely recognized. However, little is known about the prevalence and the clinical consequences of the comorbidity between focal epilepsy and sleep disorders, especially those sleep phenomena classified as isolated symptoms or normal variants. Objective of the study was to evaluate the frequency of sleep disorders and physiological sleep variants in a group of adult patients with focal epilepsy as compared to healthy controls by means of nocturnal polysomnography. Methods: We performed a retrospective observational study in the Neurological Clinic of the University of Catania in adult patients with a diagnosis of focal epilepsy and in a group of control subjects. All subjects underwent an overnight polysomnography. The following sleep disorders were considered: NREM-related parasomnias; REM-related parasomnias; sleep-related movement disorders; isolated symptoms or normal variants. Results: 100 patients [mean age 30.3 ± 14.7 years, 40 men] and 62 controls [mean age 36.4 ± 15.9, 20 men] were studied. A significant higher percentage of sleep disorders was recorded in patients as compared to controls (73 % vs 48.4 %; p = 0.002). In particular, we found a higher frequency of periodic limb movements (PLM) (20 % vs 4.8 %; p = 0.007), bruxism (20 % vs 4.8 %; p = 0.007) and neck myoclonus (22 % vs 4.8 %; p = 0.003). Moreover, alternating limb muscle activation was associated with sleep-related hypermotor epilepsy (OR = 7.9; p = 0.01). Conclusion: Sleep disorders and physiological sleep variants are common in adult patients with focal epilepsy.

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“…Poor quality of sleep may be associated with the frequency of seizures, daytime somnolence and depression [23]. Furthermore, sleep disorders are considerably more common in patients with drug-resistant epilepsy and focal epilepsy [24,25]. Problems with sleep initiation are undoubtedly related to the deterioration of the quality of life in individuals with chronic diseases and in healthy ones.…”

A polysomnographic study of slow-wave sleep loss in elderly patients with epilepsy

“…There is a comorbid association between epilepsy and PLMD. Previous studies have indicated that [ 54 , 55 ] patients with epilepsy tend to experience increased periodic limb movements (PLMS) and significantly increased PLMI. However, these studies did not specifically investigate elderly patients with epilepsy.…”

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“…Furthermore, model was also able to identify seizure onset and termination more accurately than a traditional Gaussianbased approach Different sleep disorders were studied by Loretta Giuliano. Giuliano [10] used polysomnography to assess a sample of 30 patients with focal epilepsy in order to evaluate frequency of arousals, presence of sleep disordered breathing events and sleep variants. Giuliano realized that meaningfully developed arousal frequency in epileptic persons is always present.…”