Abstracts

Rationale: Patients with epilepsy experience frequent episodes of fragmented sleep which may contribute to chronic sleep loss. Enhancing sleep patterns might lead to improved quality of life in these patients. Currently, unlike some other AED-s, there is no data of the effects of clobazam, a novel AED on sleep. Therefore, we tested the hypothesis that patients with epilepsy will have longer, more consolidated sleep after treatment with clobazam. . Methods: In this prospective study, patients were included if they were 18 years or older and were being considered for treatment of epilepsy with clobazam. Patients with known untreated moderate/severe sleep apnea, or with major circadian rhythm disorders were excluded. Ten patients who started clobazam treatment were tested with a set of subjective sleep measures: Pittsburgh Sleep Quality Inventory (PSQI), Epworth Sleepiness Scale (ESS), Karolinska Sleepiness Scale (KSS), Insomnia Severity Index (ISI), and Quality of Life in Epilepsy (QOLIE) prior to starting the treatment, as well as after achieving a stable clobazam dose. They also completed a week of supportive objective assessment of sleep (wrist actigraphy) before starting therapy and one week after achieving stable dose. Results: Treatment with clobazam significantly reduced seizure frequency (p=0.02). There was a trend of subjective improvement in sleep quality (PSQI before, 7.3 ± 4.2 vs after, 6.3 ± 2.1) and quality of life (QOLIE before, 25.6 ± 6.4 vs. after, 24.8 ± 6.3), although these did not reach statistical significance. However, objective sleep measures, as measured by actigraphy, revealed that treatment with clobazam significantly reduced the number of awakenings (before, 36.2 ± 8.0 vs. after, 29.2 ± 5.4, p=0.02). Trends were observed for reduced sleep latency (minutes before, 31.2 ± 20.7 vs minutes after, 27.8 ± 19.9) and time spent awake (minutes before, 51.4. ± 20.5 vs minutes after, 36.5 ± 10.5), and there was a higher sleep efficiency (% before, 82.6 ± 7.0 vs % after, 84.5 ± 5.3) after treatment. Conclusions: In addition to reducing seizure frequency, our preliminary analyses suggest that clobazam treatment may be beneficial for sleep in patients with epilepsy and thereby improving their quality of life. However, further analyses in a larger group are needed to clarify the impact of clobazam on daytime sleepiness. Funding: This study was funded by Lundbeck Inc.