Pramod Krishnan1, Sanjib Sinha2, Arun B Taly3, Chaitra T Ramachandraiah4, Shivaji Rao5, Parthasarathy Satishchandra6. 1. National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India. Electronic address: drpramodkrishnan@gmail.com. 2. National Institute of Mental Health and Neuro Sciences, Hosur Road, Bangalore 560029, Karnataka, India. Electronic address: sanjib_sinha2004@yahoo.co.in. 3. National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: abtaly@yahoo.com. 4. Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: drchaitratr@yahoo.com. 5. National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: shivajirao.nimhans@gmail.com. 6. National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: drpsatishchandra@yahoo.com.
Abstract
PURPOSE: To study the spectra of sleep profile using PSG in a cohort of patients with JME attending a University hospital. METHODOLOGY: This prospective cross-sectional case-control study involved 25 patients of JME (age: 22.0±6.3 years; M:F=13:12) on valproic acid (VPA) and 25 matched healthy controls (age: 23.2±3.04 years; M:F=16:9) were recruited. All patients underwent clinical assessment, electroencephalogram (EEG), and evaluation with sleep questionnaire and PSG. RESULTS: PSG analysis revealed significant alterations in sleep architecture in the JME group in the form of reduced mean sleep efficiency (p=<0.035) and number of patients with reduced sleep efficiency (p=0.001), increased mean sleep onset latency (p=0.04) and number of patients with increased sleep latency (p=0.023), reduced mean N2 sleep percentage (p=0.005) and reduced mean total NREM (non-rapid eye movement) sleep (p=0.001) and increased mean wake percentage (p=0.001). The frequency of arousals, involuntary limb movements, and event related arousals in the JME groups was not different from the controls. Patients >20 years had reduced total sleep time compared to those <20 years (p=0.012). Patients with seizures for >5 years had reduced NREM sleep percentage (p=0.042) and those on VPA therapy >1 year had a longer stage 2 (p=0.03) and N3 latency (p=0.03). Patients on ≤600mg/day of VPA had a higher prevalence of isolated limb movements (p=0.01). CONCLUSIONS: PSG revealed significant alterations in sleep architecture in JME despite adequate seizure control. There was variable degree of PSG-phenotypic correlation.
PURPOSE: To study the spectra of sleep profile using PSG in a cohort of patients with JME attending a University hospital. METHODOLOGY: This prospective cross-sectional case-control study involved 25 patients of JME (age: 22.0±6.3 years; M:F=13:12) on valproic acid (VPA) and 25 matched healthy controls (age: 23.2±3.04 years; M:F=16:9) were recruited. All patients underwent clinical assessment, electroencephalogram (EEG), and evaluation with sleep questionnaire and PSG. RESULTS:PSG analysis revealed significant alterations in sleep architecture in the JME group in the form of reduced mean sleep efficiency (p=<0.035) and number of patients with reduced sleep efficiency (p=0.001), increased mean sleep onset latency (p=0.04) and number of patients with increased sleep latency (p=0.023), reduced mean N2 sleep percentage (p=0.005) and reduced mean total NREM (non-rapid eye movement) sleep (p=0.001) and increased mean wake percentage (p=0.001). The frequency of arousals, involuntary limb movements, and event related arousals in the JME groups was not different from the controls. Patients >20 years had reduced total sleep time compared to those <20 years (p=0.012). Patients with seizures for >5 years had reduced NREM sleep percentage (p=0.042) and those on VPA therapy >1 year had a longer stage 2 (p=0.03) and N3 latency (p=0.03). Patients on ≤600mg/day of VPA had a higher prevalence of isolated limb movements (p=0.01). CONCLUSIONS:PSG revealed significant alterations in sleep architecture in JME despite adequate seizure control. There was variable degree of PSG-phenotypic correlation.