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Sleep quality and circadian rhythm profile of persons with juvenile myoclonic epilepsy in a tertiary epilepsy center: A case-control study

  • Author Footnotes
    1 These authors equally contributed to this manuscript.
    Camila Koike
    Correspondence
    Corresponding author at: 785 Dr. Ovidio Pires de Campos Street, Sao Paulo, SP, ZIP Code 05403903, Brazil.
    Footnotes
    1 These authors equally contributed to this manuscript.
    Affiliations
    Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
    Search for articles by this author
  • Author Footnotes
    1 These authors equally contributed to this manuscript.
    Ellen M. Lima
    Footnotes
    1 These authors equally contributed to this manuscript.
    Affiliations
    Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
    Search for articles by this author
  • Maria L. Paiva
    Affiliations
    Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
    Search for articles by this author
  • Alvaro Pentagna
    Affiliations
    Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
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  • Isabelle Bimbatti
    Affiliations
    Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
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  • Kette D. Valente
    Correspondence
    Corresponding author at: 785 Dr. Ovidio Pires de Campos Street, Sao Paulo, SP, ZIP Code 05403903, Brazil.
    Affiliations
    Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
    Search for articles by this author
  • Author Footnotes
    1 These authors equally contributed to this manuscript.
Published:November 08, 2022DOI:https://doi.org/10.1016/j.seizure.2022.11.002

      Highlights

      • Patients with JME have worse sleep quality and a more evening chronotype.
      • Epilepsy-related factors did not predict the performance on sleep scales.
      • Pharmacoresponsiveness was associated with lower depressive and anxiety scores.
      • Pharmacoresistant JME patients had a worse sleep quality than pharmacoresistant.

      Abstract

      Purpose

      This study evaluated sleep quality, chronotype, and excessive diurnal somnolence in persons with Juvenile Myoclonic Epilepsy (JME) and their possible association with clinical variables.

      Methods

      This cross-sectional controlled study evaluated 49 consecutive patients (65% females, mean age 27.53 years) with an electroclinical diagnosis of JME and 49 healthy controls (55% females, mean age 28.55 years). The Pittsburgh Sleep Quality Inventory (PSQI) was used to assess sleep quality and the Epworth Sleepiness Scale (ESS) to evaluate excessive daytime sleepiness. The patients' chronotype was evaluated by the Morningness-Eveningness Questionnaire (MEQ). Epilepsy-related factors gathered from the medical chart and personal interview were epilepsy duration, age at onset, frequency of myoclonic (Mcl), generalized tonic-clonic (GTC) and absence (ABS) seizures, pharmacoresponse, and current antiseizure medication (ASM).

      Results

      Persons with JME did not differ from the control group regarding daytime sleepiness (p=0.840); however, the JME group had worse sleep quality (p=0.01) than the controls. Persons with JME presented a more evening chronotype than controls (p = 0.003). The age at onset, epilepsy duration, frequency of Mcl seizure, frequency of GTC seizure, frequency of ABS seizure, and drug response did not predict ESS and MEQ scales. Pharmacoresponsive patients had lower PSQI scores compared with pharmacoresistant patients (p=0.036).

      Conclusion

      Persons with JME have worse sleep quality and a more evening chronotype. Notably, pharmacoresistant patients present a worse sleep quality that deserves attention and special care due to the relationship between sleep deprivation and seizure worsening.

      Keywords

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