Dados do Trabalho

Título

SLEEP QUALITY AND CIRCADIAN RHYTHM IN JUVENILE MYOCLONIC EPILEPSY

Introdução

Endogenous central and peripheral clocks control the circadian rhythm. Seizure occurrence may have 24-hour rhythmicity, depending on the epilepsy type. Circadian rhythms may play a role in epilepsy and epilepsy syndrome. Despite its intricate relationship with sleep, the study of the circadian cycle and sleep quality in patients with JME remains poor.

Objetivo

This study aimed to evaluate sleep quality, chronotype, and excessive diurnal somnolence in consecutive patients with JME. We also aimed to assess the association between epilepsy-related factors and sleep characteristics.

Método

This cross-sectional controlled study evaluated 49 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 sleep quality was assessed by the Pittsburgh Sleep Quality Inventory (PSQI), and the excessive daytime sleepiness by Epworth Sleepiness Scale (ESS). 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 (MLC), generalized tonic-clonic (GTC) and absence (ABS) seizures, and anti-seizure medication.

Resultados

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=0.019) than the controls. Persons with JME presented a more evening chronotype than controls (p = 0.003). The age at onset, epilepsy duration, MLC seizure frequency, GTC seizure, frequency of ABS seizure, and drug-response did not predict ESS and MEQ scales. Drug-response impacted PSQI scores (p=0.036); therefore, pharmacoresponsive patients had lower scores than those with pharmacoresistant epilepsy.

Conclusões

Patients 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. A practical approach to sleep quality can break this vicious circle.