Effect of pregabalin monotherapy on sleep structure and quality of patients with focal epilepsy_Journal of Epilepsy

Authors：

WANG Yiqi ¹ , FAN Xiuqin ² , WANG Qiong ² , LUO Chenyu ¹ ,  SUN Meizhen ²

1. School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, China;
2. Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan 030001, China;

Corresponding author：

SUN Meizhen, Email: sunmeizhen213@126.com

Keywords：

Pregabalin; Epilepsy; Sleep structure; Sleep quality

DOI：

10.7507/2096-0247.202209005

Video：

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Objective To investigate the effect of anti-seizure medications (ASMs) pregabalin (PGB) monotherapy on sleep structure and quality of patients with focal epilepsy. Methods Adult patients whom newly diagnosed focal epilepsy were collected and treated with PGB monotherapy. The main outcome measures were the changes of polysomnography and video-electroencephalography (PSG-VEEG), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) in epilepsy patients with PGB and baseline. Results PGB improved significantly sleep structural parameters, including increased total sleep time (P<0.001), decreased sleep latency (P<0.001), improved sleep efficiency (P<0.001), reduced wake time after sleep onset (P<0.001), increased sleep maintenance efficiency (P<0.001) and proportion of N3 sleep stage (P<0.001). In the group with poor sleep efficiency, 86.7% of patients achieved sleep efficiency>85% after PGB treatment. The difference was statistically significant (P<0.01). PGB reduced significantly PSQI score (P<0.001) and ISI score (P<0.001). No significant change in ESS score was observed (P>0.05). Conclusions PGB could enhance slow-wave sleep (SWS), increase sleep quality and improve insomnia in patients with epilepsy without causing daytime sleepiness.

Citation： WANG Yiqi, FAN Xiuqin, WANG Qiong, LUO Chenyu, SUN Meizhen. Effect of pregabalin monotherapy on sleep structure and quality of patients with focal epilepsy. Journal of Epilepsy, 2023, 9(3): 181-185. doi: 10.7507/2096-0247.202209005 Copy

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2.	Grigg-Damberger MM, Foldvary-Schaefer N. Sleep and epilepsy: practical implications. Neurologic clinics, 2022, 40(4): 769-783.
3.	Tian N, Wheaton AG, Zack M, et al. Sleep duration and quality among U. S. adults with epilepsy: National Health Interview Survey 2013, 2015, and 2017. Epilepsy & Behavior, 2021, 122: 108194.
4.	Roliz AH, Kothare S. The interaction between sleep and epilepsy. Current neurology and neuroscience reports, 2022, 22(9): 551-563.
5.	Samsonsen C, Sand T, Brathen G, et al. The impact of sleep loss on the facilitation of seizures: a prospective case-crossover study. Epilepsy research, 2016, 127: 260-266.
6.	Jain SV, Glauser TA. Effects of epilepsy treatments on sleep architecture and daytime sleepiness: an evidence-based review of objective sleep metrics. Epilepsia, 2014, 55(1): 26-37.
7.	Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: efficacy and tolerability of the new antiepileptic drugs I: treatment of new-onset epilepsy: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 2018, 91(2): 74-81.
8.	Merica H, Gaillard JM. Statistical description and evaluation of the interrelationships of standard sleep variables for normal subjects. Sleep, 1985, 8(3): 261-273.
9.	Kanner AM, Bicchi MM. Antiseizure medications for adults with epilepsy: a review. JAMA, 2022, 327(13): 1269-1281.
10.	Roebber JK, Lewis PA, Crunelli V, et al. Effects of anti-seizure medication on sleep spindles and slow waves in drug-resistant epilepsy. Brain Sciences, 2022, 12(10): 12110.
11.	Hindmarch I, Dawson J, Stanley N. A double-blind study in healthy volunteers to assess the effects on sleep of pregabalin compared with alprazolam and placebo. Sleep, 2005, 28(2): 187-193.
12.	Bazil CW, Dave J, Cole J, et al. Pregabalin increases slow-wave sleep and may improve attention in patients with partial epilepsy and insomnia. Epilepsy & Behavior, 2012, 23(4): 422-425.
13.	de Haas S, Otte A, de Weerd A, et al. Exploratory polysomnographic evaluation of pregabalin on sleep disturbance in patients with epilepsy. Journal of Clinical Sleep Medicine, 2007, 3(5): 473-478.
14.	Romigi A, Izzi F, Marciani M G, et al. Pregabalin as add-on therapy induces REM sleep enhancement in partial epilepsy: a polysomnographic study. European Journal of Neurology, 2009, 16(1): 70-75.

1. Grigg-Damberger M, Foldvary-Schaefer N. Bidirectional relationships of sleep and epilepsy in adults with epilepsy. Epilepsy & Behavior, 2021, 116: 107735.
2. Grigg-Damberger MM, Foldvary-Schaefer N. Sleep and epilepsy: practical implications. Neurologic clinics, 2022, 40(4): 769-783.
3. Tian N, Wheaton AG, Zack M, et al. Sleep duration and quality among U. S. adults with epilepsy: National Health Interview Survey 2013, 2015, and 2017. Epilepsy & Behavior, 2021, 122: 108194.
4. Roliz AH, Kothare S. The interaction between sleep and epilepsy. Current neurology and neuroscience reports, 2022, 22(9): 551-563.
5. Samsonsen C, Sand T, Brathen G, et al. The impact of sleep loss on the facilitation of seizures: a prospective case-crossover study. Epilepsy research, 2016, 127: 260-266.
6. Jain SV, Glauser TA. Effects of epilepsy treatments on sleep architecture and daytime sleepiness: an evidence-based review of objective sleep metrics. Epilepsia, 2014, 55(1): 26-37.
7. Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: efficacy and tolerability of the new antiepileptic drugs I: treatment of new-onset epilepsy: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 2018, 91(2): 74-81.
8. Merica H, Gaillard JM. Statistical description and evaluation of the interrelationships of standard sleep variables for normal subjects. Sleep, 1985, 8(3): 261-273.
9. Kanner AM, Bicchi MM. Antiseizure medications for adults with epilepsy: a review. JAMA, 2022, 327(13): 1269-1281.
10. Roebber JK, Lewis PA, Crunelli V, et al. Effects of anti-seizure medication on sleep spindles and slow waves in drug-resistant epilepsy. Brain Sciences, 2022, 12(10): 12110.
11. Hindmarch I, Dawson J, Stanley N. A double-blind study in healthy volunteers to assess the effects on sleep of pregabalin compared with alprazolam and placebo. Sleep, 2005, 28(2): 187-193.
12. Bazil CW, Dave J, Cole J, et al. Pregabalin increases slow-wave sleep and may improve attention in patients with partial epilepsy and insomnia. Epilepsy & Behavior, 2012, 23(4): 422-425.
13. de Haas S, Otte A, de Weerd A, et al. Exploratory polysomnographic evaluation of pregabalin on sleep disturbance in patients with epilepsy. Journal of Clinical Sleep Medicine, 2007, 3(5): 473-478.
14. Romigi A, Izzi F, Marciani M G, et al. Pregabalin as add-on therapy induces REM sleep enhancement in partial epilepsy: a polysomnographic study. European Journal of Neurology, 2009, 16(1): 70-75.

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