title: Reduction of rapid eye movement sleep by diurnal and nocturnal seizures in temporal lobe epilepsy.
abstract: BACKGROUND
  Patients with brief, complex partial seizures frequently suffer from tiredness and decreased productivity that continue well beyond the postictal period. A possible explanation is that seizures, even when occurring during the day, disrupt sleep the following night.
  
  
  OBJECTIVE
  To determine the effect of temporal lobe complex partial seizures on sleep structure and daytime drowsiness.
  
  
  METHODS
  Patients with temporal lobe epilepsy were admitted for video-electroencephalography monitoring. All-night polysomnography was recorded under the following 3 conditions: seizure free, seizure during the day before the recording, and seizure during the recording. Percentage of time in each sleep stage, sleep efficiency, and time to first and second rapid eye movement (REM) period were compared for seizure vs control conditions. Daytime drowsiness was also measured, using a modified maintenance of wakefulness test and 2 subjective drowsiness tests.
  
  
  RESULTS
  Daytime seizures reduced REM from 18%+/-1% to 12%+/-2% (P = .003). Night seizures reduced REM from 16%+/-1% to 6.8%+/-2% (P<.001). Night seizures also significantly reduced stages 2 and 4 while increasing stage 1 sleep. Night seizures, but not day seizures, significantly reduced sleep efficiency, increased time to first REM period, and increased drowsiness as measured by the maintenance of wakefulness test.
  
  
  CONCLUSIONS
  Temporal lobe complex partial seizures decrease REM sleep, particularly when occurring during sleep but also when occurring on the previous day. This may, in part, be responsible for the prolonged impairment of functioning that some patients report following seizures.
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Center, Columbia-Presbyterian Medical Center, New York, NY 10032, USA. cwb11@columbia.edu
authors.forename: C W
authors.initials: CW
authors.lastname: Bazil
authors.forename: L H
authors.initials: LH
authors.lastname: Castro
authors.forename: T S
authors.initials: TS
authors.lastname: Walczak
mesh_terms: D000328:Adult; D002940:Circadian Rhythm; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology*; D005133:Eye Movements / Q000502:physiology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology*