Highlights
- •We studied the effect of partial sleep deprivation on seizure occurrence.
- •Adults with epilepsy recorded 237 seizures and sleep and wake periods for 1 month.
- •Sleep time was not different between preseizure and seizure-free periods.
- •Napping, sleepiness, fatigue, and insomnia symptoms were commonly reported.
- •Small degrees of sleep loss were not associated with seizures in our sample.
Abstract
Background
Prolonged sleep deprivation activates epileptiform EEG abnormalities and seizures
in people with epilepsy. Few studies have addressed the effect of chronic partial
sleep deprivation on seizure occurrence in populations with epilepsy. We tested the
primary hypothesis that partial sleep deprivation over 24- and 72-hour periods increases
seizure occurrence in adults with epilepsy.
Methods
Forty-four subjects completed a series of self-reported instruments, as well as 1-month
sleep and seizure diaries, to characterize their sleep and quality of life. Diaries
were used to determine the relationship between seizure occurrence and total sleep
time 24 and 72 h before seizure occurrence using random effects models and a logistic regression
model fit by generalized estimating equations.
Results
A total of 237 seizures were recorded during 1295 diary days, representing 5.5 ± 7.0 (mean ± SD) seizures per month. Random effects models for 24- and 72-hour total sleep times
showed no clinically or statistically significant differences in the total sleep time
between preseizure periods and seizure-free periods. The average 24-hour total sleep
time during preseizure 24-hour periods was 8 min shorter than that during seizure-free periods (p = 0.51). The average 72-hour total sleep time during preseizure periods was 20 min longer than that during seizure-free periods (p = 0.86). The presence of triggers was a significant predictor of seizure occurrence,
with stress/anxiety noted most often as a trigger. Mean total sleep time was 9 h, and subjects took an average of 12 ± 10 naps per month, having a mean duration of 1.9 ± 1.2 h. Daytime sleepiness, fatigue, and insomnia symptoms were commonly reported.
Conclusions
Small degrees of sleep loss were not associated with seizure occurrence in our sample
of adults with epilepsy. Our results also include valuable observations of the altered
sleep times and frequent napping habits of adults with refractory epilepsy and the
potential contribution of these habits to quality of life and seizure control.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic and PersonalCorporate R&D ProfessionalsOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Epilepsy & BehaviorAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- 2009 sleep in America poll summary of findings.National Sleep Foundation, 2009
- 2012 sleep in America poll — summary of findings.2012
- Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies.Sleep. 2010; 33: 585-592
- The electroencephalogram during prolonged experimental sleep deprivation.Electroencephalogr Clin Neurophysiol. 1962; 14: 544-551
- Sleep deprivation seizures.Neurology. 1973; 23: 678-686
- Sleep deprivation and major motor convulsions.Neurology. 1963; 13: 953-958
- Sleep and epilepsy.Semin Neurol. 2009; 29: 419-428
- Efficacy of sleep deprivation as an activation procedure in epilepsy patients.J Clin Neurophysiol Off Publ Am Electroencephalogr Soc. 1984; 1: 83-101
- Correlations between night sleep duration and seizure frequency in temporal lobe epilepsy.Epilepsia. 1993; 34: 574-579
- Seizure occurrence: precipitants and prediction.Neurology. 2007; 69: 1905-1910
- Distribution of seizure precipitants among epilepsy syndromes.Epilepsia. 2000; 41: 1534-1539
- Self-perception of seizure precipitants and their relation to anxiety level, depression, and health locus of control in epilepsy.Seizure. 2008; 17: 302-307
- Sleep deprivation does not affect seizure frequency during inpatient video-EEG monitoring.Neurology. 2002; 59: 1371-1374
- A brief questionnaire to screen for quality of life in epilepsy: the QOLIE-10.Epilepsia. 1996; 37: 577-582
- The development of a seizure severity scale as an outcome measure in epilepsy.Epilepsy Res. 1991; 8: 245-251
- A brief measure for assessing generalized anxiety disorder: the GAD-7.Arch Intern Med. 2006; 166: 1092-1097
- The PHQ-9: validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- EuroQol — a new facility for the measurement of health-related quality of life.Health Policy Amst Neth. 1990; 16: 199-208
- A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale.Sleep. 1991; 14: 540-545
- The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus.Arch Neurol. 1989; 46: 1121-1123
- Validation of the Insomnia Severity Index as an outcome measure for insomnia research.Sleep Med. 2001; 2: 297-307
- The Sleep Disorders Questionnaire. I: Creation and multivariate structure of SDQ.Sleep. 1994; 17: 160-167
- Obstructive sleep apnea in epilepsy patients: the Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ) is a useful screening instrument for obstructive sleep apnea in a disease-specific population.Sleep Med. 2003; 4: 517-521
- Catamenial epilepsy.Int Rev Neurobiol. 2008; 83: 79-90
- The role of stress as a trigger for epileptic seizures: a narrative review of evidence from human and animal studies.Epilepsia. 2013; 54: 1866-1876
- Which seizure-precipitating factors do patients with epilepsy most frequently report?.Epilepsy Behav. 2005; 6: 85-89
- Alcohol and drugs in epilepsy: pathophysiology, presentation, possibilities, and prevention.Epilepsia. 2012; 53: 48-57
- Sleep duration and mortality: a systematic review and meta-analysis.J Sleep Res. 2009; 18: 148-158
- Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4–5 hours per night.Sleep. 1997; 20: 267-277
- The cumulative cost of additional wakefulness: dose–response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation.Sleep. 2003; 26: 117-126
- Level of sleepiness and total sleep time following various time in bed conditions.Sleep. 1993; 16: 226-232
- Insomnia and epilepsy: a questionnaire-based study.J Clin Sleep Med. 2013; 9: 141-146
- Influence of sleep disturbance on quality of life of patients with epilepsy.Seizure. 2008; 17: 588-594
- Sleep disturbances, socioeconomic status, and seizure control as main predictors of quality of life in epilepsy.Epilepsy Behav. 2005; 7: 481-485
- Epilepsy: accuracy of patient seizure counts.Arch Neurol. 2007; 64: 1595-1599
- Subjective sleep disturbance in patients with partial epilepsy: a questionnaire-based study on prevalence and impact on quality of life.Epilepsia. 2004; 45: 1397-1404
- Quality of life in patients at first time visit for sleep disorders of breathing at a sleep centre.Health Qual Life Outcomes. 2013; 11: 207
- Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States.Soc Sci Med. 2010; 71: 1027-1036
- Sleep disturbances in people with epilepsy; prevalence, impact and treatment.Sleep Med Rev. 2011; 15: 357-368
- Sleep–wake habits and disorders in a series of 100 adult epilepsy patients — a prospective study.Seizure J Br Epilepsy Assoc. 2006; 15: 299-306
- Markedly disturbed sleep in medically refractory compared to controlled epilepsy — a clinical and polysomnography study.Seizure J Br Epilepsy Assoc. 2012; 21: 487-490
- Sleep apnea and epilepsy: who's at risk?.Epilepsy Behav. 2012; 25: 363-367
Article Info
Publication History
Published online: January 23, 2015
Accepted:
December 9,
2014
Received in revised form:
December 8,
2014
Received:
August 15,
2014
Footnotes
☆This research was funded by the Epilepsy Foundation Health Sciences Student Fellowship (Grant number 211619 ), the Cleveland Clinic Lerner College of Medicine , and a Cleveland Clinic Neurological Institute Knowledge Program Pilot Project grant.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
