Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients

Beth A. Malow, J. Edwards, M. Marzec, O. Sagher, Donald (Don) Ross, G. Fromes

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Background: Given that vagal afferents project to brainstem regions that promote alertness, the authors tested the hypothesis that vagus nerve stimulation (VNS) would improve daytime sleepiness in patients with epilepsy. Methods: Sixteen subjects with medically refractory seizures underwent polysomnography and multiple sleep latency tests (MSLT) and completed the Epworth Sleepiness Scale (ESS), a measure of subjective daytime sleepiness, before and after 3 months of VNS. Most subjects (>80%) were maintained on constant doses of antiepileptic medications. Results: In the 15 subjects who completed baseline and treatment MSLT, the mean sleep latency (MSL) improved from 6.4 ± 4.1 minutes to 9.8 ± 5.8 minutes (± SD; p = 0.033), indicating reduced daytime sleepiness. All subjects with stimulus intensities of ≤1.5 mA showed improved MSL. In the 16 subjects who completed baseline and treatment ESS, the mean ESS score decreased from 7.2 ± 4.4 to 5.6 ± 4.5 points (p = 0.049). Improvements in MSLT and ESS were not correlated with reduction in seizure frequency. Sleep-onset REM periods occurred more frequently in treatment naps as compared to baseline naps (p <0.008; Cochran-Mantel-Haenszel test). The amount of REM sleep or other sleep stages recorded on overnight polysomnography did not change with VNS treatment. Conclusions: Treatment with VNS at low stimulus intensities improves daytime sleepiness, even in subjects without reductions in seizure frequency. Daytime REM sleep is enhanced with VNS. These findings support the role of VNS in activating cholinergic and other brain regions that promote alertness.

Original languageEnglish (US)
Pages (from-to)879-884
Number of pages6
JournalNeurology
Volume57
Issue number5
StatePublished - Sep 11 2001
Externally publishedYes

Fingerprint

Vagus Nerve Stimulation
Epilepsy
Sleep
REM Sleep
Seizures
Polysomnography
Therapeutics
Sleep Stages
Anticonvulsants
Cholinergic Agents
Brain Stem
Brain

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Malow, B. A., Edwards, J., Marzec, M., Sagher, O., Ross, D. D., & Fromes, G. (2001). Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients. Neurology, 57(5), 879-884.

Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients. / Malow, Beth A.; Edwards, J.; Marzec, M.; Sagher, O.; Ross, Donald (Don); Fromes, G.

In: Neurology, Vol. 57, No. 5, 11.09.2001, p. 879-884.

Research output: Contribution to journalArticle

Malow, BA, Edwards, J, Marzec, M, Sagher, O, Ross, DD & Fromes, G 2001, 'Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients', Neurology, vol. 57, no. 5, pp. 879-884.
Malow BA, Edwards J, Marzec M, Sagher O, Ross DD, Fromes G. Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients. Neurology. 2001 Sep 11;57(5):879-884.
Malow, Beth A. ; Edwards, J. ; Marzec, M. ; Sagher, O. ; Ross, Donald (Don) ; Fromes, G. / Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients. In: Neurology. 2001 ; Vol. 57, No. 5. pp. 879-884.
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