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Semin Neurol 2009; 29(4): 419-428
DOI: 10.1055/s-0029-1237115
© Thieme Medical Publishers

Sleep and Epilepsy

Nancy Foldvary-Schaefer1 , Madeleine Grigg-Damberger2
  • 1Cleveland Clinic Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
  • 2Pediatric Sleep Medicine Services, University of New Mexico School of Medicine, Albuquerque, New Mexico
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Publikationsverlauf

Publikationsdatum:
09. September 2009 (online)

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ABSTRACT

Over a century of work has confirmed crucial links between sleep and epilepsy. Seizures and some antiepileptic drugs (AEDs) adversely affect the continuity of sleep. However, sleep is fragmented in the absence of seizures or medication, suggesting that sleep instability may be an inherent component of certain forms of epilepsy. In turn, sleep instability can promote seizures, thus forming a vicious cycle. Sleep deprivation provokes seizures and epileptiform discharges in some people with epilepsy. Synchronized nonrapid eye movement (NREM) sleep facilitates seizures, whereas desynchronized rapid eye movement (REM) sleep discourages seizure occurrence. The sleep electroencephalogram (EEG) is useful in the diagnosis and localization of epilepsy, as new epileptic foci can appear in sleep and REM sleep may demonstrate the narrowest localization of the primary focus. Polysomnography (PSG) with expanded EEG aids in the differentiation of seizures and parasomnias and in the diagnosis of primary sleep disorders, such as sleep apnea, that can exacerbate seizures. Treating sleep apnea may lead to improved seizure control. These observations underscore the importance of sleep in the diagnosis and treatment of people with epilepsy.

KEYWORDS

Sleep - epilepsy - seizures - interictal discharges - sleep disorders

REFERENCES

  • 1 Féré L. Les épilepsies and les épileptiques. Vol. I. Paris; Alcan 1880
    PubMedSuche in Google Scholar
  • 2 Gowers W R. Epilepsy and Other Chronic Convulsive Diseases: Their Causes, Symptoms and Treatment. London; Churchill 1985
    PubMedSuche in Google Scholar
  • 3 Langdon-Down M, Brain W R. Time of day in relation to convulsions in epilepsy.  Lancet. 1929;  1 2029-2032
    PubMedSuche in Google Scholar
  • 4 Janz D. Epilepsy and the sleeping-waking cycle. In: Vinken PJ, Bruyn GW The Epilepsies: Handbook of Clinical Neurology. Amsterdam; North-Holland Publishing Company 1974: 457-490
    PubMedSuche in Google Scholar
  • 5 Gibberd F B, Bateson M C. Sleep epilepsy: its pattern and prognosis.  Br Med J. 1974;  25 403-405
    PubMedSuche in Google Scholar
  • 6 D'Alessandro R, Guarino M, Greco G, Bassein L. Emilia-Romagna Study Group on Clinical and Epidemiological Problems in Neurology . Risk of seizures while awake in pure sleep epilepsies: a prospective study.  Neurology. 2004;  62(2) 254-257
    PubMedSuche in Google Scholar
  • 7 Crespel A, Coubes P, Baldy-Moulinier M. Sleep influence on seizures and epilepsy effects on sleep in partial frontal and temporal lobe epilepsies.  Clin Neurophysiol. 2000;  111(Suppl 2) S54-S59
    CrossrefPubMedSuche in Google Scholar
  • 8 Herman S T, Walczak T S, Bazil C W. Distribution of partial seizures during the sleep—wake cycle: differences by seizure onset site.  Neurology. 2001;  56(11) 1453-1459
    PubMedSuche in Google Scholar
  • 9 Jobst B C, Williamson P D, Neuschwander T B, Darcey T M, Thadani V M, Roberts D W. Secondarily generalized seizures in mesial temporal epilepsy: clinical characteristics, lateralizing signs, and association with sleep-wake cycle.  Epilepsia. 2001;  42(10) 1279-1287
    CrossrefPubMedSuche in Google Scholar
  • 10 Pavlova M K, Shea S A, Bromfield E B. Day/night patterns of focal seizures.  Epilepsy Behav. 2004;  5(1) 44-49
    CrossrefPubMedSuche in Google Scholar
  • 11 Quigg M, Staume M, Menaker M, Bertram III E H. Temporal distribution of partial seizures: comparison of an animal model with human partial epilepsy.  Ann Neurol. 1998;  43 748-755
    CrossrefPubMedSuche in Google Scholar
  • 12 Gibbs E L, Gibbs F A. Diagnostic and localizing value of electroencephalographic studies in sleep.  Res Publ Assoc Res. Nerv Ment Dis. 1947;  26 366-376
    PubMedSuche in Google Scholar
  • 13 Malow B A, Bowes R J, Lin X. Predictors of sleepiness in epilepsy patients.  Sleep. 1997;  20(12) 1105-1110
    PubMedSuche in Google Scholar
  • 14 Sammaritano M, Gigli G L, Gotman J. Interictal spiking during wakefulness and sleep and the localization of foci in temporal lobe epilepsy.  Neurology. 1991;  41(2 ( Pt 1)) 290-297
    PubMedSuche in Google Scholar
  • 15 Montplaisir J, Laverdière M, Saint-Hilaire J M, Rouleau I. Nocturnal sleep recording in partial epilepsy: a study with depth electrodes.  J Clin Neurophysiol. 1987;  4(4) 383-388
    PubMedSuche in Google Scholar
  • 16 Sato S, Dreifuss F, Penry J K. The effect of sleep on spike-wave discharges in absence seizures.  Neurology. 1973;  23 1335-1345
    PubMedSuche in Google Scholar
  • 17 Shouse M N, Farber P R, Staba R J. Physiological basis: how NREM sleep components can promote and REM sleep components can suppress seizure discharge propagation.  Clin Neurophysiol. 2000;  111(Suppl 2) S9-S18
    CrossrefPubMedSuche in Google Scholar
  • 18 Steriade M, Contreras D, Amzica F. Synchronized sleep oscillations and their paroxysmal developments.  Trends Neurosci. 1994;  17(5) 199-208
    CrossrefPubMedSuche in Google Scholar
  • 19 Gloor P, Tsai C, Haddad F. An assessment of the value of sleep-electroencephalography for the diagnosis of temporal lobe epilepsy.  Electroencephalogr Clin Neurophysiol. 1958;  10(4) 633-648
    PubMedSuche in Google Scholar
  • 20 Salih F, Khatami R, Steinheimer S, Kretz R, Schmitz B, Grosse P. A hypothesis for how non-REM sleep might promote seizures in partial epilepsies: a transcranial magnetic stimulation study.  Epilepsia. 2007;  48(8) 1538-1542
    CrossrefPubMedSuche in Google Scholar
  • 21 Marini C, Guerrini R. The role of the nicotinic acetylcholine receptors in sleep-related epilepsy.  Biochem Pharmacol. 2007;  74(8) 1308-1314
    CrossrefPubMedSuche in Google Scholar
  • 22 Picard F, Bertrand S, Steinlein O K, Bertrand D. Mutated nicotinic receptors responsible for autosomal dominant nocturnal frontal lobe epilepsy are more sensitive to carbamazepine.  Epilepsia. 1999;  40 1198-1209
    CrossrefPubMedSuche in Google Scholar
  • 23 Ellingson R J, Wilken K, Bennett D R. Efficacy of sleep deprivation as an activation procedure in epilepsy patients.  J Clin Neurophysiol. 1984;  1(1) 83-101
    PubMedSuche in Google Scholar
  • 24 Degen R, Degen H E. Sleep and sleep deprivation in epileptology.  Epilepsy Res Suppl. 1991;  (2) 235-260
    PubMedSuche in Google Scholar
  • 25 Haut S R, Hall C B, Masur J, Lipton R B. Seizure occurrence: precipitants and prediction.  Neurology. 2007;  69(20) 1905-1910
    CrossrefPubMedSuche in Google Scholar
  • 26 Rajna P, Veres J. Correlations between night sleep duration and seizure frequency in temporal lobe epilepsy.  Epilepsia. 1993;  34(3) 574-579
    CrossrefPubMedSuche in Google Scholar
  • 27 Mattson R H, Pratt K L, Calverley J R. Electroencephalograms of epileptics following sleep deprivation.  Arch Neurol. 1965;  13(3) 310-315
    PubMedSuche in Google Scholar
  • 28 Rowan A J, Veldhuisen R J, Nagelkerke N JD. Comparative evaluation of sleep deprivation and sedated sleep EEGs as diagnostic aids in epilepsy.  Electroencephalogr Clin Neurophysiol. 1982;  54(4) 357-364
    PubMedSuche in Google Scholar
  • 29 Roupakiotis S C, Gatzonis S D, Triantafyllou N et al.. The usefulness of sleep and sleep deprivation as activating methods in electroencephalographic recording: contribution to a long-standing discussion.  Seizure. 2000;  9(8) 580-584
    CrossrefPubMedSuche in Google Scholar
  • 30 Foldvary-Schaefer N, Grigg-Damberger M. Sleep and epilepsy: what we know, don't know, and need to know.  J Clin Neurophysiol. 2006;  23(1) 4-20
    PubMedSuche in Google Scholar
  • 31 Placidi F, Diomedi M, Scalise A, Marcianni M G, Romigi A, Gigli G L. Effect of anticonvulsants on nocturnal sleep in epilepsy.  Neurology. 2000;  54(5 Suppl 1) S25-32
    PubMedSuche in Google Scholar
  • 32 Rizzo P, Beelke M, De Carli F et al.. Chronic vagus nerve stimulation improves alertness and reduces rapid eye movement sleep in patients affected by refractory epilepsy.  Sleep. 2003;  26(5) 607-611
    PubMedSuche in Google Scholar
  • 33 Marzec M, Edwards J, Sagher O, Fromes G, Malow B A. Effects of vagus nerve stimulation on sleep-related breathing in epilepsy patients.  Epilepsia. 2003;  44(7) 930-935
    CrossrefPubMedSuche in Google Scholar
  • 34 Nagarajan L, Walsh P, Gregory P et al.. Respiratory pattern changes in sleep in children with vagal nerve stimulation for refractory epilepsy.  Can J Neurol Sci. 2003;  30 224-227
    PubMedSuche in Google Scholar
  • 35 Malow B A, Edwards J, Marzec M, Sagher O, Fromes G. Effects of vagus nerve stimulation on respiration during sleep: a pilot study.  Neurology. 2000;  55(10) 1450-1454
    CrossrefPubMedSuche in Google Scholar
  • 36 Touchon J, Baldy-Moulinier M, Billiard M, Besset A, Cadilhac J. Sleep organization and epilepsy. In: Degen R, Rodin EA Epilepsy, Sleep and Sleep Deprivation. 2nd ed. Amsterdam; Elsevier 1991: 73-81
    PubMedSuche in Google Scholar
  • 37 Besset A. Influence of generalized seizures on sleep organization. In: Sterman MB, Shouse N, Passouant P Sleep and Epilepsy. New York; Academic Press 1982: 339-346
    PubMedSuche in Google Scholar
  • 38 Bazil C W, Castro L HM, Walczak T S. Reduction of rapid eye movement sleep by diurnal and nocturnal seizures in temporal lobe epilepsy.  Arch Neurol. 2000;  57(3) 363-368
    CrossrefPubMedSuche in Google Scholar
  • 39 Collaborative Group for Epidemiology of Epilepsy . Adverse reactions to antiepileptic drugs: a multicenter survey of clinical practice.  Epilepsia. 1986;  27(4) 323-330
    CrossrefPubMedSuche in Google Scholar
  • 40 Weintraub D B, Resor S R, Bazil C W, Hirsch L J. Head to head comparison of the sedating effect of antiepileptic drugs in adults with epilepsy.  Neurology. 2005;  64 A22-A23
    PubMedSuche in Google Scholar
  • 41 Armaganijan A F, Ehrhardt M V, Teixeira V et al.. Epworth Sleepiness Scale (ESS) in partial seizure patients.  Sleep. 2000;  23 349 (Abstract)
    PubMedSuche in Google Scholar
  • 42 Abad-Alegría F, López-Mallén M E, de Francisco-Maqueda P. Insomnia and somnolence in epilepsy.  Rev Neurol. 1997;  25(144) 1171-1172
    PubMedSuche in Google Scholar
  • 43 de Weerd A, de Haas S, Otte A et al.. Subjective sleep disturbance in patients with partial epilepsy: a questionnaire-based study on prevalence and impact on quality of life.  Epilepsia. 2004;  45(11) 1397-1404
    CrossrefPubMedSuche in Google Scholar
  • 44 Drake Jr M E, Weate S J, Newell S A, Padamadan H, Pakalnis A. Multiple sleep latency tests in epilepsy.  Clin Electroencephalogr. 1994;  25(2) 59-62
    PubMedSuche in Google Scholar
  • 45 Salinsky M C, Oken B S, Binder L M. Assessment of drowsiness in epilepsy patients receiving chronic antiepileptic drug therapy.  Epilepsia. 1996;  37(2) 181-187
    CrossrefPubMedSuche in Google Scholar
  • 46 Malow B A, Levy K, Maturen K, Bowes R. Obstructive sleep apnea is common in medically refractory epilepsy patients.  Neurology. 2000;  55(7) 1002-1007
    PubMedSuche in Google Scholar
  • 47 Chihorek A M, Abou-Khalil B, Malow B A. Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy.  Neurology. 2007;  69(19) 1823-1827
    CrossrefPubMedSuche in Google Scholar
  • 48 Devinsky O, Ehrenberg B, Barthlen G M, Abramson H S, Luciano D. Epilepsy and sleep apnea syndrome.  Neurology. 1994;  44(11) 2060-2064
    PubMedSuche in Google Scholar
  • 49 Vaughn B V, D'Cruz O F, Beach R, Messenheimer J A. Improvement of epileptic seizure control with treatment of obstructive sleep apnoea.  Seizure. 1996;  5(1) 73-78
    CrossrefPubMedSuche in Google Scholar
  • 50 Oliveira A J, Zamagni M, Dolso P, Bassetti M A, Gigli G L. Respiratory disorders during sleep in patients with epilepsy: effect of ventilatory therapy on EEG interictal epileptiform discharges.  Clin Neurophysiol. 2000;  111(Suppl 2) S141-S145
    CrossrefPubMedSuche in Google Scholar
  • 51 Zucconi M, Oldani A, Ferini-Strambi L, Bizzozero D, Smirne S. Nocturnal paroxysmal arousals with motor behaviors during sleep: frontal lobe epilepsy or parasomnia?.  J Clin Neurophysiol. 1997;  14(6) 513-522
    PubMedSuche in Google Scholar
  • 52 Foldvary-Schaefer N, De Ocampo J, Mascha E, Burgess R, Dinner D, Morris H. Accuracy of seizure detection using abbreviated EEG during polysomnography.  J Clin Neurophysiol. 2006;  23(1) 68-71
    PubMedSuche in Google Scholar
  • 53 Derry C P, Davey M, Johns M et al.. Distinguishing sleep disorders from seizures: diagnosing bumps in the night.  Arch Neurol. 2006;  63(5) 705-709
    CrossrefPubMedSuche in Google Scholar

Nancy Foldvary-SchaeferD.O. 

Director, Cleveland Clinic Sleep Disorders Center, Neurological Institute, Cleveland Clinic

9500 Euclid Avenue, FA 20, Cleveland, OH 44195

eMail: foldvan@ccf.org