Abstract
Sleep is a reversible behavioural state of perceptual disengagement from and unresponsiveness to the environment, which is required for neural plasticity and memory consolidation. Sleep disorders are common in patients with epilepsy. The main causes of sleep disturbances are coexisting sleep disorders, impact of seizures and epileptic activity, and the effects of antiepileptic drugs. Sleep and epilepsy have reciprocal effects - on one hand electrical brain activity during sleep is a strong modulator of epileptic activity and on the other epileptic activity during sleep may disrupt sleep architecture. The most common side effects of anticonvulsants include alterations in sleep architecture and variation in the degree of daytime sleepiness. Their effects on sleep and daytime sleepiness are variable and it is often difficult to distinguish whether the improved seizure control and epileptic activity is a direct result of anticonvulsants or associated with improved sleep quality. Levetiracetam is a new generation anticonvulsant used to treat both focal and generalized epilepsy. Its satisfactory safety and tolerability explain its wide usage in the clinical practice and necessitates more profound knowledge on its effects on sleep quality. There have been few reports about its effects on sleep architecture and daytime sleepiness. A short summary of the studies concerning this topic is presented. Main disadvantages of the studies are: the small sample size, comparison of the results obtained in healthy volunteers with patients with epilepsy, short observation duration, variations of dosage, different evaluation modalities and concomitant AED therapy. Future prospective studies on subjective and objective effects of Levetiracetam on sleep architecture and daytime sleepiness are needed to better understand its impact on sleep in order to improve epilepsy patients' quality of life, seizure control and sleep disturbances.
Highlights
Sleep is a reversible behavioural state of perceptual disengagement from and unresponsiveness to the environment.[1]
The effects of antiepileptic drugs (AEDs) on sleep and daytime sleepiness are variable and it is often difficult to distinguish whether the improved seizure control and epileptic activity is a direct result of AEDs or associated with improved sleep quality
In 2002, Bell et al published the results of a study on the effects of LEV on objective and subjective sleep parameters in healthy volunteers and patients with focal epilepsy on stable chronic (>1 year) CBZ monotherapy.[20]
Summary
Sleep is a reversible behavioural state of perceptual disengagement from and unresponsiveness to the environment.[1]. Electrical brain activity during sleep is a strong modulator of epileptic activity, and vice versa, epileptic activity during sleep may impair the sleep–wake cycle and sleep architecture.[14] All this can result in sleep deprivation, which in turn may provoke subsequent seizures.[15] The effects of AEDs on sleep and daytime sleepiness are variable and it is often difficult to distinguish whether the improved seizure control and epileptic activity is a direct result of AEDs or associated with improved sleep quality. The most common side effects of AEDs include alterations in sleep architecture and variation in the degree of daytime sleepiness.[16] The main difference between older and newer AEDs concerns especially daytime sleepiness, more often associated with conventional traditional AEDs, newer AEDs are reported to be less sleep disruptive.[9,15] Older generation AEDs typically reduce the percentage of REM sleep and SWS, increase fragmentation, and induce daytime sleepiness.[8]. We present a short summary of the studies (in ascending chronological order of publishing) concerning this topic
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