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Medicina
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Epilepsy, Seizures, and Sleep Disorders
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Epilepsy, Seizures, and Sleep Disorders

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 1370

Special Issue Editors

Prof. Dr. Giedrė Jurkevičienė

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Guest Editor
Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
Interests: epilepsy; electroencephalography; relationship between sleep; sleep–wake rhythm; clinical; laboratory; electroencephalographic characteristics and cognitive functions in patients with genetic generalized epilepsy
Dr. Evelina Pajediene

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Guest Editor
Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
Interests: sleep–wake rhythm (circadian) disorders in neurological diseases; sleep-related biomarkers in the early detection and management of neurodegenerative disorders; sleep-related wearables and AI-based innovations
Prof. Dr. Renata Balnyte

E-Mail Website
Guest Editor
Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, 50161 Kaunas, Lithuania
Interests: epilepsy; electroencephalography; relationship between sleep; sleep–wake rhythm; clinical; laboratory; electroencephalographic characteristics and cognitive functions in patients with genetic generalized epilepsy

Special Issue Information

Dear Colleagues,

The global burden of neurological disorders is substantially growing. As mentioned in the World Health Organization’s new Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031, future specialists should focus on prevention and effective management of the most common neurological diseases, such as stroke, dementia, headaches, and epilepsy.

Epilepsy is a frequent neurological disease that significantly decreases the quality of life (QoL), especially in patients with drug-resistant epilepsy. Epileptic seizures (ESs), particularly those with impaired consciousness, falls, or inappropriate behavior, complicate the QoL and can be life-threatening. Coexisting comorbidities, including sleep disorders, can significantly affect seizure frequency and QoL. Sleep complaints are highly prevalent in epilepsy patients and are about twice as common as in healthy individuals. The interactions between sleep and epilepsy are complex. Sleep alteration negatively impacts seizure control; sleep deprivation is a key trigger of genetically generalized epilepsies. As a further point in this complex relationship, ES may occur exclusively during sleep, complicating the diagnosis of sleep disorders such as parasomnias. This complexity is compounded by the adverse effects of antiseizure medications, which can lead to disturbed nighttime sleep and daytime sleepiness. The bidirectional relationship between sleep and epilepsy significantly impacts sleep health and epilepsy outcomes. Therefore, improving sleep quality may constitute a way to improve the global management of patients with epilepsy.

Over the past few years, the relationship between sleep and epilepsy has increased interest among the sleep and epileptology research communities. A better understanding of this interrelation seems important in both the fields of epileptology and sleep physiology. With this Special Issue dedicated to epilepsy and sleep disorders, we would like to invite scientific and clinical experts to publish their original research papers as well as reviews about the interplay between epilepsy and disturbed sleep, sleep–wake rhythm biomarkers in various neurological disorders, and their role in disease prevention and management. In this Special Issue, we would like to highlight the role of circadian biomarkers in the early diagnostics of Parkinson’s disease and dementias, as well as the potential of light therapy and melatonin-based interventions for challenges in narcolepsy and other central hypersomnia diagnostics and management.

Prof. Dr. Giedrė Jurkevičienė
Dr. Evelina Pajediene
Prof. Dr. Renata Balnyte
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • epilepsy
  • seizure
  • antiseizure medications
  • adverse effects of anti-seizure medications
  • quality of life
  • electroencephalography
  • sleep
  • sleep disorders
  • insomnia
  • daytime sleepiness
  • sleep–wake rhythm
  • circadian
  • hypersomnia
  • narcolepsy

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Published Papers (2 papers)

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Research

16 pages, 2034 KiB  
Article
Can We Reduce the Diagnostic Burden of Sleep Disorders? A Single-Centre Study of Subjective and Objective Sleep-Related Diagnostic Parameters
by Tadas Vanagas, Domantė Lipskytė, Jovita Tamošiūnaitė, Kęstutis Petrikonis and Evelina Pajėdienė
Medicina 2025, 61(5), 780; https://doi.org/10.3390/medicina61050780 - 23 Apr 2025
Viewed by 240
Abstract
Background and Objectives: Sleep disorders are highly prevalent in society and require focused attention within healthcare systems. While patient history, reported complaints, and subjective sleep questionnaires can provide initial insights into potential sleep issues, polysomnography (PSG) remains the gold standard for diagnosing various [...] Read more.
Background and Objectives: Sleep disorders are highly prevalent in society and require focused attention within healthcare systems. While patient history, reported complaints, and subjective sleep questionnaires can provide initial insights into potential sleep issues, polysomnography (PSG) remains the gold standard for diagnosing various sleep disorders. However, long waiting times for PSG appointments in many healthcare facilities pose challenges for timely diagnosis and treatment. This study aimed to evaluate the diagnostic value of subjective measures, including patient-reported parameters, in comparison to the objective findings of PSG. Materials and Methods: In this study, we retrospectively analysed the data from 562 patients who underwent clinical evaluation and PSG testing at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics between 2018 and 2024. We report the diagnostic accuracy of different sleep questionnaires to detect various sleep disorders in our population. Results: We report the corresponding sensitivity and specificity values: the Epworth Sleepiness Scale (ESS)—73.2% and 44.1% for detecting severe obstructive sleep apnoea and 87.1% and 76.8% for detecting hypersomnia; the Insomnia Severity Index (ISI)—77.2% and 63.3% for detecting insomnia; the Berlin Questionnaire (BQ)—67.8% and 68.8% for detecting obstructive sleep apnoea; the Ullanlina Narcolepsy Scale (UNS)—84.4% and 58.9% for detecting hypersomnia; the Innsbruck REM Sleep Behaviour Disorder Inventory (RBD-I)—93.3% and 52.5% for detecting RBD; the REM Sleep Behaviour Disorder Single-Question Screen (RBD1Q)—73.3% and 81.0% for detecting RBD; and the Paris Arousal Disorder Severity Scale (PADSS)—57.5% and 90.5% for detecting parasomnia. Conclusions: When comparing our findings with the previous literature, we found that the screening tools generally demonstrated a slightly poorer performance in our population. However, our results suggest that certain individual questions from the comprehensive questionnaires may provide comparable diagnostic values, while reducing the patient burden. We propose a targeted screening approach that integrates fundamental clinical parameters, key screening questions, and selected validated questionnaires, enabling primary care and outpatient clinicians to more efficiently identify patients who may require referral for specialised sleep evaluation and treatment. Full article
(This article belongs to the Special Issue Epilepsy, Seizures, and Sleep Disorders)
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12 pages, 1254 KiB  
Article
Introducing the Index of Response to Stimulation (IRES): A Novel Metric for Assessing Vagus Nerve Stimulation Outcomes in Drug-Resistant Epilepsy
by Flavius-Iuliu Urian, Corneliu Toader, Razvan-Adrian Covache Busuioc, Antonio-Daniel Corlatescu, Horia Petre Costin, Gabriel Iacob and Alexadru Vlad Ciurea
Medicina 2025, 61(1), 75; https://doi.org/10.3390/medicina61010075 - 4 Jan 2025
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Abstract
Background and Objectives: The Index of Response to Stimulation (IRES) is a new index that we introduce in this study to grade the effectiveness of vagus nerve stimulation in the treatment of drug-resistant epilepsy. We assessed 76 patients at 6, 12, and [...] Read more.
Background and Objectives: The Index of Response to Stimulation (IRES) is a new index that we introduce in this study to grade the effectiveness of vagus nerve stimulation in the treatment of drug-resistant epilepsy. We assessed 76 patients at 6, 12, and 18 months after VNS evaluating improvement with the IRES in four key dimensions: seizure duration decrease, seizure intensity decrease, improvement in quality of life, and seizure frequency decrease. This scale goes from 0, meaning no improvement, to 8, meaning maximal improvement, making the scale a really good measure of clinical utility. Materials and Methods: This retrospective study followed 76 patients aged 20–65, assessing changes in their IRES scores after VNS therapy using the ASPIRE SR 106 device. Therapy settings were adjusted biweekly to optimize efficacy and patient tolerance. Results: There were improvements in the control of the seizures, measured in terms of increased IRES scores. Improvements were associated with quality-of-life enhancements for the patient and a lesser frequency and intensity of the seizures, testifying further to the predictive ability of the IRES toward successful outcomes. This fact reveals that epilepsy treatment must be individual, according to the profile of the patient. Conclusions: The study confirms the IRES to be a valid tool for the assessment of the impact of VNS on drug-resistant epilepsy and promotes it as an integral part of the evaluation of the patient for personalized therapy. The findings encourage the use of IRES among the elements that support patient selection and insist on its role in the advancement of precision medicine and optimization of treatment. Full article
(This article belongs to the Special Issue Epilepsy, Seizures, and Sleep Disorders)
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