Sleep Disturbances in Epilepsy

Epilepsy and seizures exert a significant and enduring effect on sleep in epilepsy patients. Nocturnal generalised tonic-clonic seizures as well as multiple complex partial seizures distort sleep architecture and result in excessive daytime sleepiness. There is a lack of REM rebound in the successive nights. Furthermore, the chronic epileptic condition especially in focal epilepsy causes a disturbed sleep architecture independently of seizures. Epilepsy patients suffer from a 2- to 3-fold increased prevalence of subjective sleep disturbances as compared to the general population. Sleep disturbances are associated with a significant impairment in quality of life. Children with epilepsy suffer from sleep problems more often than healthy children. Sleep impairment in children with epilepsy causes behavioural problems and reduced quality of life. With a prevalence of 30-50% excessive daytime sleepiness represents the most frequent sleep-related disturbance in epilepsy patients and could be documented with objective tests. Obstructive sleep apnea (OSA) occurs in 10-33% of epilepsy patients and thus significantly more often than in the general population. Possible mechanisms include the effects of central nervous system depressant antiepileptic drugs, weight gain induced by antiepileptic drugs and the increased incidence of polycystic ovary syndrome in women with epilepsy. OSA can lead to an exacerbation of seizures. On the contrary, successful treatment of OSA results in improved seizure control.