Sleep and waking disturbances in epilepsy.
We compared sleep parameters during three-hour postprandial nap recordings in 10 normal controls and 28 seizure patients. Patients had significantly less sleep, longer sleep latency, more wakefulness, less drowsiness and lighter nonREM sleep, and lower sleep efficiency than controls. Generalized seizure patients had longer sleep latency, more arousals, and more (but very little) stage III sleep. Those with partial seizures had more stage II sleep and greater sleep efficiency. Patients on polypharmacy and phenobarbital therapy slept more, phenytoin patients had very short sleep latency but more wakefulness and less sleep efficiency; those taking clonazepam were also awake more and had lower sleep efficiency, while arousals during sleep were more frequent in patients on valproate and carbamazepine. The findings suggest that disturbed sleep, possibly related to aberrant arousal occasioned by generalized epilepsy or epileptogenic foci, is common in seizure patients, and may be related to interictal behavioral and cognitive symptoms. Polypharmacy may have an additive effect on sleep to prolong and disrupt it, while sedative anti-epileptic drugs may increase sleep and other anti-epileptic medications may have alerting effects or interfere with falling asleep. Generalized and partial seizure patients may have sleep disturbances of a different character, possibly reflecting generally altered cerebral excitability by afferent stimuli in the former situation, and the more localized effects of limbic or cortical hyperactivity in the latter.
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D004569:Electroencephalography; D004576:Electromyography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012894:Sleep Stages / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D014851:Wakefulness / Q000187:drug effects
D000927:Anticonvulsants