Instruments for the sleep analysis in patients with epilepsy

by Andrea Romigi, Professor at UniCamillus

During an exciting afternoon of work online supported by the pharmaceutical company EISAI, more than 250 Italian and Spanish neurologists expert in epilepsy and sleep met to discuss issues of “sleep epileptology”.

Four of the leading European experts on this topic have addressed numerous issues, from the differential diagnosis of nocturnal motor events (somnanbulism and sleep-related forms of epilepsy), to the diagnostic procedures recently clarified by the joint guidelines of the European Academy of Neurology, International League Against Epilepsy and of European Research, up to the effects of anti-epileptic drugs on sleep.

During the conference I focused on the need for greater sensitivity and knowledge of neurologists and epilepticologists in studying sleep and daytime sleepiness at 360 ° in the patient with epilepsy with both objective (polysomnography) and subjective (questionnaires) methods.

The relationship between sleep and epilepsy has always been considered bidirectional and, therefore, any phenomenon that worsens the control of epilepsy or night sleep fragments tends to negatively affect the other condition.

In these situations, insidious sleep comorbidities can often hide, such as sleep apnea, restless legs syndrome, nocturnal myoclonus, more rarely central hypersomnia, or other that can result in fragmentation of nocturnal sleep, somnolence and consequent worsening of pharmacological control of epilepsy.

Somnolence, in addition to increasing the risk of accidents, is correlated with a lower adherence to pharmacological treatments for patients suffering from epilepsy and consequently a greater risk of clinical worsening, in a vicious circle that further increases the levels of sleepiness. The solution is sometimes very simple. When necessary, resorting to in-depth polysomnography studies on sleep allows you to find these disorders and treat them with the consequent improvement not only of the sleep problem but also of the control of epilepsy.

It is therefore essential to have clear ideas and skills on sleep and epilepsy that become increasingly complementary and to achieve the final goal of improving the quality of life of our patients.

The work of the congress ended with the promise of an annual comparison, we hope in presence, which compares different points of view and always increases the levels of training in this field.

Andrea Romigi is Professor of Child Neuropsychiatry in the Degree Course in Physiotherapy and Neurophysiology and Posture in the Online Master in Clinical Posturology at UniCamillus.

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