Expert Opinion: Managing sleep disturbances in people with epilepsy

Lino Nobili*, Sándor Beniczky, Sofia H Eriksson, Andrea Romigi, Philippe Ryvlin, Manuel Toledo, Ivana Rosenzweig

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Abstract

Poor sleep and daytime sleepiness are common in people with epilepsy. Sleep disorders can disrupt seizure control and in turn sleep and vigilance problems can be exacerbated by seizures and by antiepileptic treatments. Nevertheless, these aspects are frequently overlooked in clinical practice and a clear agreement on the evidence-based guidelines for managing common sleep disorders in people with epilepsy is lacking. Recently, recommendations to standardize the diagnostic pathway for evaluating patients with sleep-related epilepsies and comorbid sleep disorders have been presented. To build on these, we adopted the Delphi method to establish a consensus within a group of experts and we provide practical recommendations for identifying and managing poor night-time sleep and daytime sleepiness in people with epilepsy. We recommend that a comprehensive clinical history of sleep habits and sleep hygiene should be always obtained from all people with epilepsy and their bed partners. A psychoeducational approach to inform patients about habits or practices that may negatively influence their sleep or their vigilance levels should be used, and strategies for avoiding these should be applied. In case of a suspected comorbid sleep disorder an appropriate diagnostic investigation should be performed. Moreover, the possible presence of sleep fragmentation induced by sleep-related seizures should be ruled out. Finally, the dose and timing of antiepileptic medications and other co-medications should be optimized to improve nocturnal sleep and avoid daytime sedation.

OriginalsprogEngelsk
Sider (fra-til)108341
TidsskriftEpilepsy and Behavior
Vol/bind124
Tidlig onlinedato4 okt. 2021
DOI
StatusUdgivet - 1 nov. 2021

Bibliografisk note

Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

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