The effect of levetiracetam monotherapy on subjective sleep quality and objective sleep parameters in patients with epilepsy: Compared with the effect of carbamazepine-CR monotherapy

PURPOSE There is relatively little known about the effects of new antiepileptic drugs (AEDs) on sleep. This study was done to evaluate the effect of levetiracetam (LEV) on subjective sleep quality and sleep architecture in patients with epilepsy, and the results were compared with the effects of carbamazepine-CR (CBZ-CR). METHODS This is a longitudinal randomized controlled trial using two different treatments, LEV (1000 mg/day) or CBZ-CR (400mg/day). Thirty-one subjects (16 LEV and 15 CBZ-CR) had partial epilepsy and were tested with an overnight polysomnography (PSG) with full 10-20 electrodes. Sleep questionnaires and National Hospital Seizure severity Scale (NHS3) were evaluated. PSG and the questionnaires were repeated after 4-6 weeks of treatment. RESULTS In the LEV group, when treatment PSG findings were compared with baseline, there was a significant increase in sleep efficiency (p=0.039) but no changes in subjective sleep parameters. In the CBZ-CR group, there was a significant increase in the percentage of slow wave sleep (p=0.038) while other sleep parameters were not significantly changed after treatment. There were no significant differences in effects on sleep between the LEV and CBZ-CR groups. CONCLUSION LEV may increase sleep efficiency without major effects on sleep structure with an overall effect on sleep parameters comparable to CBZ-CR.