Background

epilepsia

Epilepsy and paroxysmal conditions

Эпилепсия и пароксизмальные состояния

2077-83332311-4088

IRBIS LLC

10.17749/2077-8333/epi.par.con.2024.194

epilepsia-1151

Research Article

SCIENTIFIC SURVEYS

НАУЧНЫЕ ОБЗОРЫ

Epilepsy and sleep: current diagnostic and treatment approaches

Эпилепсия и сон: современные подходы к диагностике и лечению

https://orcid.org/0000-0003-3635-5850

Шова

Н. И.

Shova

N. I.

Шова Наталья Игоревна - к.м.н.

ул. Бехтерева, д. 3, Санкт-Петербург, 192019

WoS ResearcherID AAI-3755-2020, Scopus Author ID 57215893698

Natalia I. Shova - PhD.

3 Bekhterev Str., Saint Petersburg, 192019

WoS ResearcherID AAI-3755-2020, Scopus Author ID 57215893698

https://orcid.org/0000-0002-1786-3916

Большакова

А. К.

Bolshakova

A. K.

Большакова Алиса Константиновна.

ул. Бехтерева, д. 3, Санкт-Петербург, 192019

Alisa K. Bolshakova.

3 Bekhterev Str., Saint Petersburg, 192019

98bolshakova@gmail.com

https://orcid.org/0000-0002-7700-2704

Михайлов

В. А.

Mikhailov

V. A.

Михайлов Владимир Алексеевич - д.м.н.

ул. Бехтерева, д. 3, Санкт-Петербург, 192019

WoS Researcher ID B-3272-2017

Vladimir A. Mikhailov - Dr. Sci. Med.

3 Bekhterev Str., Saint Petersburg, 192019

WoS Researcher ID B-3272-2017

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской ФедерацииРоссияBekhterev National Medical Research Center for Psychiatry and NeurologyRussian Federation

2024

18012025

164362374

2025

Шова Н.И., Большакова А.К., Михайлов В.А.

Shova N.I., Bolshakova A.K., Mikhailov V.A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.epilepsia.su/jour/article/view/1151

Background

Background. Multiple complicated interactions exist between sleep and epilepsy – sleep activating effect on emerging epileptic seizures, altered sleep pattern due to epileptic activity, antiepileptic drugs impact on sleep pattern in epilepsy patients, as well as comorbidity of sleep disorders and epilepsy.

Objective

Objective: exploring a literature-based relationship between sleep and epileptic activity, as well as approaches to the diagnosis and treatment of sleep disorders in epilepsy.

Material and methods

Material and methods. Current literature review examined the data of presented analysis assessing a relationship between epilepsy and sleep. Publications were searched in the electronic databases PubMed/MEDLINE and eLibrary using key words and phrases: “epilepsy”, “sleep”, “antiepileptic drugs”, “sleep disorders”, “insomnia”, “obstructive sleep apnea syndrome”, “restless legs syndrome”, “depression”, “anxiety”, “non-psychotic mental disorders” in Russian and English.

Results

Results. A literature review revealed complex relationships between epilepsy and sleep disorders. Epileptic activity, especially at night, can fragment sleep, reducing its restorative potential and provoking higher seizure incidence and severity. It was also shown that different antiepileptic drugs (AEDs) have ambiguous effects on sleep patterns: sedative AEDs may improve sleep, but may cause excessive daytime sleepiness if dosage and timing of administration are inappropriate. Challenges in differential diagnosis of sleep disorders in epilepsy treatment were highlighted, requiring a multidisciplinary approach due to the difficulty in distinguishing between symptoms caused by both epileptic activity and AEDs side effects as well as associated psychiatric disorders. To address these issues, an algorithm for diagnosis and correction of sleep disorders in epilepsy patients was proposed, aimed at optimizing therapy and improving the quality of life in this patient cohort.

Conclusion

Conclusion. Sleep disorders in patients with epilepsy can lead to the formation of a “vicious circle” and worsen the course of both diseases, therefore, it is necessary to ensure their timely diagnosis and correction.

Актуальность

Актуальность. Между сном и эпилепсией имеются многочисленные сложные взаимодействия – активирующее влияние сна на возникновение эпилептических приступов, нарушение структуры сна эпилептической активностью, влияние противоэпилептических препаратов на структуру и качество сна у пациентов с эпилепсией, а также коморбидность нарушений сна и эпилепсии.

Цель

Цель: изучение взаимосвязи между сном и эпилептической активностью, подходов к диагностике и лечению нарушений сна при эпилепсии по данным литературы.

Материал и методы

Материал и методы. Изучены результаты современных исследований, посвященных взаимосвязи эпилепсии и сна. Поиск публикаций проводили в электронных базах данных PubMed/MEDLINE и eLibrary по ключевым словам и словосочетаниям: «эпилепсия», «сон», «противоэпилептические препараты», «расстройства сна», «инсомния», «синдром обструктивного апноэ сна», «синдром беспокойных ног», «депрессия», «тревога», «непсихотические психические расстройства» на русском и английском языках.

Результаты

Результаты. Обзор литературы выявил сложные взаимосвязи между эпилепсией и нарушениями сна. Эпилептическая активность, особенно в ночное время, может фрагментировать сон, снижая его восстановительный потенциал и провоцируя увеличение частоты и тяжести приступов. Также различные противоэпилептические препараты (ПЭП) оказывают неоднозначное влияние на структуру сна: седативные ПЭП могут способствовать улучшению сна, однако при неправильно подобранной дозировке и времени приема вызывают избыточную дневную сонливость. Имеют место трудности дифференциальной диагностики нарушений сна при лечении эпилепсии, требующем мультидисциплинарного подхода из-за сложности разграничения симптомов, вызванных как эпилептической активностью, так и побочными эффектами ПЭП и сопутствующими психическими расстройствами. Для решения этих проблем предложен алгоритм диагностики и коррекции нарушений сна у больных эпилепсией, направленный на оптимизацию терапии и улучшение качества жизни у данной группы пациентов.

Заключение

Заключение. Нарушения сна у больных эпилепсией могут привести к формированию «порочного круга» и ухудшению течения обоих заболеваний, в связи с чем необходимо обеспечить их своевременное выявление и коррекцию.

Эпилепсиясоннарушения снаинсомниянепсихотические психические расстройстватревогадепрессиясиндром обструктивного апноэ снасиндром беспокойных ног

Epilepsysleepsleep disordersinsomnianon-psychotic mental disordersanxietydepressionobstructive sleep apnea syndromerestless legs syndrome

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The authors declare that there are no conflicts of interest present.