Sleep disorders in patients with juvenile myoclonic epilepsy: A polysomnographic investigation

Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epilepsy precipitated by sleep deprivation and display a circadian distribution.

This study aimed to determine the frequency of sleep disorders (insomnia, snorring, sleep apnea, restless leg syndrome, bruxism, hipersomnia) and sleep architecture in JME, to evaluate associations with seizure variables and antiseizure medications, and to investigate polysomnographic parameters.

Forty adults with JME and thirty healthy controls underwent overnight laboratory-based polysomnography. Participants completed the Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Insomnia and restless legs syndrome (RLS) were assessed according to ICSD-3 criteria. Sleep architecture, respiratory indices and periodic limb movements were analyzed. Patients on valproate(VPA) were compared with those on levetiracetam. Correlations between epilepsy duration, seizure frequency, and sleep parameters were also examined.

JME patients showed significantly prolonged sleep latencies to N1, N2 stages. Minimum nocturnal oxygen saturation was lower, OSAS(obstructive sleep apnea syndrome), snoring were more frequent in JME group. Longer epilepsy duration correlated with poorer sleep efficiency, shorter total sleep time, and reduced N3 sleep, as well as increased wake after sleep onset. VPA was associated with higher BMI, higher AHI(Apnea hypopnea index) and ODI(oxygen desaturation index), lower minimum oxygen saturation, and lower QoLIE-31 "seizure worry" subscores.

JME is characterized by prolonged NREM stage latencies, increased snoring, OSA and lower oxygen saturation. VPA therapy was associated with more severe respiratory disturbance, likely related to weight gain. Sleep disorders should routinely be screened for and appropriately managed in patients with JME, and antiepileptic treatment choices should be made with these factors in mind.