Epilepsy and Sleep are related
Dr. Sameh Morkous is a child neurologist practicing in Philadelphia, PA. Dr Morkous is a Clinical Professor of Pediatrics and Board certified in Child Neurology, Sleep & Epilepsy Medicine through the American Board of Psychiatry and Neurology (ABPN) after being fellowship trained in nationally... more
Although sleep appears to be a passive and restful time, it still involves a highly active and well-scripted interplay of mental activities. Epilepsy is a heterogeneous neurological condition with recognized strings to sleep health & wellness [1]. Epilepsy and sleep share a very close relation and if we improve sleep and treat any sleep disorders this will help controlling seizures and also if we control the amount of seizures then sleep will subsequently improve [2] .
Effect of Epilepsy on Sleep
Seizures are sudden uncontrolled electrical disturbance in the brain. The effect of epilepsy on sleep can be due to either the seizures or the seizure medications. The seizure can disrupt your sleep decreasing the amount of deep sleep stage called REM sleep and increase the amount of the lighter stages (called the non- Rapid Eye Movement (non-REM) sleep). Although some anti-seizure medications may improve sleep by providing better seizure control and sleep quality, but others have been reported to affect the quality of sleep and can cause side effects like problems falling asleep or staying asleep or alternatively excessive sleepiness all of which can influence our sleep [2] & [3].
Effects of Sleep on Epilepsy
Seizures does not only affect sleep but sleep also has an effect on seizures. Sleep specifically the lighter stages of sleep increases the brain seizure activity at night but on the other hand the deep sleep stage suppresses the brain activity and subsequently reducing the possibility of seizures [2]. When seizures occur 2 times or more to the same person and are more than 24 hours apart this is called epilepsy. In addition, when they have peculiar features, like starting at a certain age and/or if they have a specific pattern, they are then defined under distinctive types that are referred to medically as an epilepsy syndrome [1]. Certain epilepsy syndromes will occur mainly during sleep like Sleep Hypermotor Epilepsy (SHE) which is a rare form of epilepsy in which seizures occur mainly during sleep and are associated with vigorous physical body movements like kicking or cycling of limbs and /or rocking body movements. Also, patients with sleep apnea — a sleep disorder in which breathing will repeatedly stops and starts abnormally during asleep — can also worsen seizures. The American Academy of Sleep Medicine (AASM) recommends 12 to 16 hours per day of sleep for infants , 11 to 14 hours per day in the first 2 years of life, 10 to 13 hours per day in children 3 to 5 years, 9 to 12 hours per day in children 6 to 12 years, 8 to 10 hours per day in teenagers and 7-9 hours of sleep in adults [4]. Not getting enough sleep at night as recommended can predispose to seizures [2].
Conclusions
In conclusion, sleep and epilepsy share a reciprocal relationship affecting each other through a number of complex ways. It is vital for patients and doctors to be aware of this close relationship between these two entities. Controlling seizures will improve sleep . Moreover, using anti-seizure medications, treating underlying sleep disorders like sleep apnea and getting the recommended amounts of sleep at night can help to decrease the seizure frequency [2] & [3].
SOURCES:
The International League Against Epilepsy (ILAE) [1]
Living Well With Epilepsy - November Epilepsy Blog Relay™. ‘Sleep and epilepsy listening to your body clock will help your seizures!’ by Sameh Morkous 11/2020 https://livingwellwithepilepsy.com/2020/epilepsy-blog-relay/sleep-and-epilepsy.html [2]
E Lanigar S, Bandyopadhyay S. Sleep and Epilepsy: A Complex Interplay. Mo Med. 2017 Nov-Dec;114(6):453-457. PMID: 30228664; PMCID: PMC6139974.pilepsy Foundation [3]
The American Academy of Sleep Medicine [4]
