title: Sleep disorders in adults with epilepsy: past, present, and future directions.
abstract: OBJECTIVE
  To summarize recent studies on the complex relationships between sleep disorders, sleep, and epilepsy.
  
  
  RESULTS
  Insomnia in adults with epilepsy (AWE) warrants consideration of depression, anxiety, and suicidal ideation. Daytime sleepiness in AWE is more often due to undiagnosed sleep disorders. Sleep deprivation is an important provoker of seizures in juvenile myoclonic epilepsy. Abnormalities in frontal lobe executive function with difficulties making advantageous decisions may explain failure of juvenile myoclonic epilepsy patients to adhere to treatment recommendations and regulate their sleep habits. Sleep architecture in AWE is more likely to be abnormal if seizures are poorly controlled or occur during sleep. Obstructive sleep apnea is much more common in AWE who are man, older, heavier, or whose seizures are poorly controlled. Chronobiology and chronopharmacology of epilepsy is an emerging field worthy of future research and clinical applications.
  
  
  CONCLUSIONS
  Identifying and treating unrecognized sleep disorders and understanding the impact of circadian rhythms on epilepsy can improve quality of life and seizure control in AWE.
authors.affiliation: aDepartment of Neurology bUNM Sleep Disorder Center cDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
authors.forename: Madeleine M
authors.initials: MM
authors.lastname: Grigg-Damberger
authors.forename: Frank
authors.initials: F
authors.lastname: Ralls
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D001007:Anxiety / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004827:Epilepsy / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D011788:Quality of Life / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D012892:Sleep Deprivation / Q000139:chemically induced / Q000503:physiopathology* / Q000523:psychology; D020178:Sleep Disorders, Circadian Rhythm / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000503:physiopathology* / Q000523:psychology; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants