Bruno Miguel Santos Carvalho1, João Chaves2,3, António Martins da Silva3,4. 1. University of Porto, Abel Salazar Institute of Biomedical Sciences - Porto - Portugal. 2. Centro Hospitalar do Porto, Serviço de Neurologia, Departamento Neurociências, Hospital de Santo António - Porto - Portugal. 3. University of Porto, UMIB - Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto - Porto - Portugal. 4. Centro Hospitalar do Porto, Serviço de Neurofisiologia, Departamento de Neurociências, Hospital de Santo António - Porto - Portugal.
Abstract
Objectives: Physiological and restorative sleep is fundamental for physical and mental well-being. Polysomnography parameters are objective methods to access sleep structure. Antiepileptic drugs (AEDs) are a group of drugs whose interference in the sleep structure is still not well known, especially in what concern the new ones. We did a systematic review of the literature to compare the effect of classic and newer AEDs on sleep architecture. Material and Methods: A search was performed in PubMed and Scopus, using keywords "sleep" and "antiepileptics", and each AED combined with "sleep". Only studies concerning objective measures were selected. Results: 63 articles were included, only 21 were randomized, controlled and double-blinded. Studies not only in epilepsy, but also in restless leg syndrome, bruxism, insomnia, fibromyalgia and obstructive sleep apnea were found. Among classic AEDs, carbamazepine has a negative effect on sleep while phenobarbitone has a slightly dose-dependent interference and is also the only one to reduce N3 stage. Valproic acid has little to no effect while clobazam and clonazepam have a positive effect. No conclusion can be drawn about phenytoin. All of them reduce REM stage. In the newer AEDs group gabapentine, lamotrigine, perampanel, pregabaline and tiagabine increase N3 sleep in best evidence. Lacosamide and zonisamide appear to be innocent while levetiracetam reduces REM sleep. Conclusion: Studies found used different methodologies not always addressing the analysis on the same parameters. In spite of these, newer AEDs have less effects on sleep structure when compared with classic AEDs but furthermore robust evidence is needed.
Objectives: Physiological and restorative sleep is fundamental for physical and mental well-being. Polysomnography parameters are objective methods to access sleep structure. Antiepileptic drugs (AEDs) are a group of drugs whose interference in the sleep structure is still not well known, especially in what concern the new ones. We did a systematic review of the literature to compare the effect of classic and newer AEDs on sleep architecture. Material and Methods: A search was performed in PubMed and Scopus, using keywords "sleep" and "antiepileptics", and each AED combined with "sleep". Only studies concerning objective measures were selected. Results: 63 articles were included, only 21 were randomized, controlled and double-blinded. Studies not only in epilepsy, but also in restless leg syndrome, bruxism, insomnia, fibromyalgia and obstructive sleep apnea were found. Among classic AEDs, carbamazepine has a negative effect on sleep while phenobarbitone has a slightly dose-dependent interference and is also the only one to reduce N3 stage. Valproic acid has little to no effect while clobazam and clonazepam have a positive effect. No conclusion can be drawn about phenytoin. All of them reduce REM stage. In the newer AEDs group gabapentine, lamotrigine, perampanel, pregabaline and tiagabine increase N3 sleep in best evidence. Lacosamide and zonisamide appear to be innocent while levetiracetam reduces REM sleep. Conclusion: Studies found used different methodologies not always addressing the analysis on the same parameters. In spite of these, newer AEDs have less effects on sleep structure when compared with classic AEDs but furthermore robust evidence is needed.
Authors: Richard K Bogan; Daniel O Lee; Mark J Buchfuhrer; Mark J Jaros; Richard Kim; Gwendoline Shang Journal: Ann Med Date: 2015-04-15 Impact factor: 4.709
Authors: Santiago Perez-Lloret; Gloria Meza Rojas; Maria Celia Menoni; Gabriela Ruiz; Carolina Velásquez; Hernán Rodriguez; María Verónica Rey; And Daniel P Cardinali Journal: Clin Neuropharmacol Date: 2012 Jan-Feb Impact factor: 1.592
Authors: Raffaele Ferri; Sara Marelli; Luigi Ferini-Strambi; Alessandro Oldani; Francesca Colli; Carlos H Schenck; Marco Zucconi Journal: Sleep Med Date: 2012-10-23 Impact factor: 3.492