The value of partial sleep deprivation as a routine measure in pediatric electroencephalography

For more than 50 years it has been known that in patients with epilepsy, sleep markedly increases the diagnostic yield of the electroencephalogram (EEG). Sleep deprivation could have an additional activating role. Many laboratories do not use these methods routinely but reserve them for a second EEG if equivocal or negative findings are present in the initial EEG. We studied a regime of routine partial sleep deprivation without the use of hypnotic agents in 396 children younger than age 17 years who were referred for EEG with a diagnosis of epilepsy or suspected epilepsy. Sleep was achieved for the EEG in 77% (96% in the 1 month to 2 year age group, 78% in the 2 to 8 year age group, and in 64% of those more than 8 years old). In a comparison group of 72 children who had not been sleep-deprived, sleep was achieved in 44% (69% of those less than 2 years old, 27% of those between 2 and 8 years of age, and 33% of those older than 8 years). The differences were highly significant. The regime was well tolerated. Routine partial sleep deprivation is a practical and effective method of obtaining sleep and thus maximizing the information obtained from a single EEG.