Some PSG studies found patients with epilepsy had decreased REM sleep compared to healthy controls (TLE and JME). Furthermore, patients with refractory epilepsy had decreased percentage of REM sleep compared to those with medically controlled epilepsy.
Medications ( i.e, BZDs) are well known to decrease REM sleep. However, decreased REM sleep has also been observed among drug-naive patients with epilepsy.
-> Is the decrease of rapid eye movement sleep a cause or consequence of epilepsy?
Wei-Chih Yeh
Sir, it's difficult to envision how reduced REM sleep per se could cause epilepsy. There is no evidence for such a cause-effect relationship in the human REM deprivation literature.
However, explanations and data do exist for how reduced REM sleep could be a consequence of epilepsy. Any factor that reduces NREM sleep quality or quantity may in turn reduce REM sleep. Seizures during sleep most commonly occur during NREM sleep and thus compromise it. Sleep disorders such as sleep apnea may also interfere with NREM sleep and even trigger NREM sleep-related seizures, both of which could reduce REM sleep. As you state, some medications for epilepsy may reduce REM sleep.
This answer carries the caveat that I am a sleep specialist but not a neurologist.
Thanks,
REFERENCES
Article Sleep and Epilepsy: A Complex Interplay
https://pubmed.ncbi.nlm.nih.gov/190977/
Article Bidirectional relationships of sleep and epilepsy in adults ...
Hi,
Here are some references in this area:
Frauscher B, Gotman J. Sleep, oscillations, interictal discharges, and seizures in human focal epilepsy. Neurobiol Dis. 2019 Jul;127:545-553. doi: 10.1016/j.nbd.2019.04.007
Wang YQ, Zhang MQ, Li R, Qu WM, Huang ZL. The Mutual Interaction Between Sleep and Epilepsy on the Neurobiological Basis and Therapy. Curr Neuropharmacol. 2018;16(1):5-16. doi: 10.2174/1570159X15666170509101237
Hamdy MM, Elfatatry AM, Mekky JF, Hamdy E. Rapid eye movement (REM) sleep and seizure control in idiopathic generalized epilepsy. Epilepsy Behav. 2020 Jun;107:107064. doi: 10.1016/j.yebeh.2020.107064
Foldvary-Schaefer N, Grigg-Damberger M. Sleep and epilepsy. Semin Neurol. 2009 Sep;29(4):419-28. doi: 10.1055/s-0029-1237115
Kellaway P. Sleep and epilepsy. Epilepsia. 1985;26 Suppl 1:S15-30. doi: 10.1111/j.1528-1157.1985.tb05720.x
Khachatryan SG, Tunyan YS. Vliianie épilepsii na strukturu sna [An effect of epilepsy on sleep structure]. Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(9. Vyp. 2):88-94. Russian. doi: 10.17116/jnevro20171179288-94
Kang X, Boly M, Findlay G, Jones B, Gjini K, Maganti R, Struck AF. Quantitative spatio-temporal characterization of epileptic spikes using high density EEG: Differences between NREM sleep and REM sleep. Sci Rep. 2020 Feb 3;10(1):1673
Nakamura M, Jin K, Kato K, Itabashi H, Iwasaki M, Kakisaka Y, Nakasato N. Differences in sleep architecture between left and right temporal lobe epilepsy. Neurol Sci. 2017 Jan;38(1):189-192. doi: 10.1007/s10072-016-2731-6
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