Health Psychology Research / HPR / Online First / DOI: 10.14440/hpr.0261
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RESEARCH ARTICLE

Perampanel Effects on Sleep in Epilepsy Patients: A Pilot Case Series on Its Therapeutic Potential for Sleep Disorders

Takahiro Igarashi1* ,  Naoki Otani1 ,  Atsuo Yoshino1
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1 Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan
HPR, e81240040 https://doi.org/10.14440/hpr.0261
Submitted: 18 August 2025 | Revised: 27 September 2025 | Accepted: 24 October 2025 | Published: 14 November 2025
(This article belongs to the Special Issue Connecting Mind to Body: the Psychosomatic Perspective)
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background

Sleep disorders are common among individuals with epilepsy, often leading to disturbances in sleep patterns and architecture. Certain anti-seizure medications adversely affect sleep independently of their anti-seizure effects.

Objective

This study aims to examine the impact of perampanel (PER) on sleep disorders in patients with epilepsy.

Methods

The effects of adjunctive PER therapy on circadian rhythm and daytime sleepiness were evaluated in epilepsy patients with comorbid sleep disorders. Twenty-one eligible patients were included, excluding those with liver failure or psychological disorders. This pilot case series assessed participants using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale. PER blood concentrations were measured. Patients were selected based on baseline PSQI scores ≥6 (mean 11.57 ± 2.77).

Results

After 3 months of PER administration, the mean global PSQI score significantly improved to 6.71 ± 5.00 (p<0.01). Improvements were observed in PSQI components: C1 (sleep quality), C2 (sleep latency), and C6 (frequency of sleep medication use). A strong positive correlation was found between changes in PSQI scores (delta-PSQI = post-PER − pre-PER score) and PER blood concentrations (r = 0.71, p<0.01).

Conclusion

Adjunctive PER therapy significantly improved subjective sleep quality in epilepsy patients with comorbid sleep disorders. The correlation between the magnitude of improvements and PER blood concentration suggests a dose–response relationship. These findings indicate that PER may be a beneficial therapeutic option for managing sleep disturbances in this population and support the need for further investigation in larger, controlled studies.

Keywords
α-amino-3-hydroxy-5-methyl-4-isoxazolepropanoic acid receptor
Epilepsy
Perampanel
Sleep disorders
Funding
The present study was partially supported by Japan Society for the Promotion of Science KAKENHI (grant no. 24K12273).
Conflict of interest
Takahiro Igarashi and Prof. Atsuo Yoshino report personal fees and grants from Daiichi Sankyo, Eisai, and UCB Pharma. For the remaining authors, none were declared.
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Health Psychology Research, Electronic ISSN: 2420-8124 Published by Health Psychology Research
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