Seizures and Sleep

Excerpt

This chapter highlights recent advances in our understanding of the bidirectional interactions between sleep and epilepsy. It describes underlying neuronal correlates of sleep oscillations and epileptic activity followed by an overview of how epileptic activity during the interictal and ictal state relates to sleep. It highlights effects of sleep microstructure and sleep stability on epileptic activity, with slow oscillations and sleep fragmentation enhancing epileptic activity, and phasic rapid-eye-movement sleep having suppressive properties. Moreover, it discusses evidence of the contribution of sleep studies for improved identification of the epileptogenic zone and prediction of seizure outcome. In addition to the effects of sleep, this chapter explains how epileptic activity is influenced by longer time intervals on a day, multiday, and year scale. It then discusses how the link between epileptic activity and sleep microstructure might affect physiological functioning beyond seizures by impairing the fine-tuned orchestration of slow oscillations, spindles, and ripples necessary for memory consolidation, and reviews research addressing this question in epilepsy. Finally, the chapter provides an overview of the relationship between sudden unexplained death in epilepsy, sleep, and seizures, and discusses cardio-respiratory dysfunction as one putative mechanism. The review concludes with discussing future directions necessary to bridge current gaps in understanding, and it provides suggestions for advancing this field.