Title:The Management and Alternative Therapies for Comorbid Sleep Disorders in Epilepsy
Volume: 19
Issue: 8
Author(s): Weifeng Peng, Jing Ding*Xin Wang
Affiliation:
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai,China
Keywords:
sleep disorders, epilepsy, insomnia, sleep-disordered breathing, parasomnia, management, complementary and alternative
therapies.
Abstract:
Background: There is a complex and interactive relationship between sleep and epilepsy.
Sleep disorders are common in patients with epilepsy, and methods for managing sleep disorders
in patients with epilepsy are limited.
Objective: This review addresses the relationship among sleep, sleep disorders, and epilepsy, focusing
on the management of sleep disorders in epilepsy, including some complementary and alternative
therapies.
Methods: The terms related to “sleep” and “epilepsy” were searched in “Pubmed” and “Cochrane
Library”.
Results: Sleep stages differently affect both seizures and interictal epileptiform discharges. Seizures
disrupt sleep architecture greatly, especially when occurring during sleep in the night. Insomnia and
obstructive sleep apnea (OSA) are the most frequent types of comorbid sleep disorders in patients
with epilepsy. Pharmacological agents with both anti-convulsant and sedative effects are the priorities
for comorbid sleep disorders in epilepsy. Continuous positive airway pressure (CPAP) therapy
is the most effective non-pharmacological method to improve OSA and reduce seizures. Complementary
and alternative therapies such as Chinese traditional medicine, cognitive behavioral therapy,
meditation, yoga, neurofeedback, and acupuncture may have benefits in reducing seizures and
improving sleep quality simultaneously by alleviating stress and seizure triggers; however, evidence-
based therapies are still deficient.
Conclusion: Management of sleep disorders in patients with epilepsy is challenging. Large-scale
randomized controlled clinical trials are in demand to guide the treatments in the future.
