title: Analysis of the first night effect and sleep parameters in medically refractory epilepsy patients.
abstract: OBJECTIVE
  To assess the first night effect (FNE) and compare sleep stage proportions to normative values in a sample of medically refractory epilepsy patients.
  
  
  METHODS
  Sleep parameters of 53 epilepsy patients, ages (18-56, mean: 34+/-12, 25 females 28 men), who underwent two consecutive nights of polysomnography (PSG) were compared. Non-rapid eye movement (NREM) stage 3 and NREM stage 4 were combined as slow wave sleep (SWS). Sleep efficiency, sleep latency, rapid eye movement (REM) latency, number of stage shifts, total minutes and proportion of total sleep time for stage 1, stage 2, SWS, and REM sleep were compared between the 2 nights.
  
  
  RESULTS
  SWS was the only parameter that differed between nights 1 and 2 for both total minutes (P=0.02) and proportion of total sleep time (P=0.01), although the means for both nights were within the normative range. Comparing sleep proportions to normative values indicates that our patients had increased NREM stage 1 and decreased REM sleep.
  
  
  CONCLUSIONS
  We observed a minimal FNE in this sample of epilepsy patients manifested by reduced SWS. Multiple PSGs to accommodate the FNE may not be necessary in this population.
authors.affiliation: Michael S. Aldrich Sleep Disorders Center, Department of Neurology, University of Michigan Medical Center, 1500 E. Medical Center Dr., Rm. 8D-8702 Ann Arbor, MI 48109-0117, USA. mmarzec@umich.edu
authors.forename: Mary L
authors.initials: ML
authors.lastname: Marzec
authors.forename: Linda M
authors.initials: LM
authors.lastname: Selwa
authors.forename: Beth A
authors.initials: BA
authors.lastname: Malow
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D004562:Electrocardiography; D004569:Electroencephalography; D004576:Electromyography; D004585:Electrooculography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D012895:Sleep, REM / Q000502:physiology
chemical_list: D000927:Anticonvulsants