[The effects of epileptic seizures on sleep architecture]

Many studies have appeared in the literature that aim to analyse the influence of sleep and its stages on the behaviour of seizures, but very few look into the opposite effect, that is, the effect of the seizures on the structure of sleep. The influence exerted by a number of variables, such as the presence of seizures during the waking state prior to the study, the administration or withdrawal of antiepileptic drugs, sleep disorders during the night in the laboratory or the presence of concomitant sleep pathologies, together with the difficulties involved in monitoring or controlling all these factors gives rise to varying results in the publications examined. We offer a brief review of the components of sleep and its stages together with an update of the literature on the influence seizures exert on them.

With regard to the macrostructure of sleep, there seems to be general agreement about the fact that nocturnal generalised seizures alter the architecture of sleep, with a reduction in the efficiency of sleep and a drop in the amount of REM sleep. There also appears to be a high degree of concurrence about how recurring partial seizures on the night of the study affect the pattern of sleep, REM sleep being especially sensitive. No generalised agreement exists concerning the influence exerted by isolated partial seizures or by the seizures that take place during the waking state prior to the night the recording is made. Studies into the influence exerted by seizures on the microstructure of sleep (CAP) are scarce and are limited to specific pathologies. A deeper understanding of these interactions will provide us with key data about the clinical manifestations and the physiopathology of epileptic diseases.