Quigg Mark, Bazil Carl W, Boly Melanie, St Louis Erik K, Liu Judy, Ptacek Louis, Maganti Rama, Kalume Frank, Gluckman Bruce J, Pathmanathan Jay, Pavlova Milena K, Buchanan Gordon F
Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Columbia University, New York, NY, USA.
Epilepsy Curr. 2021 Mar 31;21(3):15357597211004566. doi: 10.1177/15357597211004566.
Epileptic seizures, sleep, and circadian timing share bilateral interactions, but concerted work to characterize these interactions and to leverage them to the advantage of patients with epilepsy remains in beginning stages. To further the field, a multidisciplinary group of sleep physicians, epileptologists, circadian timing experts, and others met to outline the state of the art, gaps of knowledge, and suggest ways forward in clinical, translational, and basic research. A multidisciplinary panel of experts discussed these interactions, centered on whether improvements in sleep or circadian rhythms improve decrease seizure frequency. In addition, education about sleep was lacking in among patients, their families, and physicians, and that focus on education was an extremely important "low hanging fruit" to harvest. Improvements in monitoring technology, experimental designs sensitive to the rigor required to dissect sleep versus circadian influences, and clinical trials in seizure reduction with sleep improvements were appropriate.
癫痫发作、睡眠和昼夜节律存在双向相互作用，但对这些相互作用进行特征描述并将其用于癫痫患者的研究仍处于起步阶段。为推动该领域发展，一组由睡眠医学专家、癫痫学家、昼夜节律专家等组成的多学科团队齐聚一堂，概述了该领域的现状、知识空白，并提出了临床、转化和基础研究的前进方向。一个多学科专家小组讨论了这些相互作用，重点是睡眠或昼夜节律的改善是否能降低癫痫发作频率。此外，患者、其家属和医生对睡眠的了解不足，而专注于教育是一个极易收获成果的重要方面。改进监测技术、设计对区分睡眠和昼夜节律影响所需的严格程度敏感的实验设计，以及开展改善睡眠以减少癫痫发作的临床试验都是合适的。
