There is a well-documented effect of nocturnal seizures on sleep. Patients have been studied in terms of their sleep architecture on nights with and without nocturnal seizures, and found to have an increase in WASO, a decrease in REM sleep, and a decrease in sleep efficiency. These effects are found with both focal and generalized seizures (Touchon, 1991). However, in the patients with temporal lobe epilepsy, he found that a significant decrease in REM sleep occurred only in the patients with multiple nocturnal seizures and not if only a single seizure occurred. In the patients with temporal lobe epilepsy, in addition to the effect of nocturnal seizures on REM sleep, a decrease in slow-wave sleep (stages 3 and 4 NREM) has been reported (Sammaritano, 1996; Castro, 1997). In addition, daytime seizures may also have an effect on sleep architecture on nights following seizures. A significant decrease in the percentage of REM sleep as well as a prolongation of the REM latency (time from sleep onset to onset of the first REM period) has been demonstrated in patients with temporal lobe epilepsy (Bazil, 1997). Hoeppner et al. (1984) reported sleep complaints in epileptics based on a self-reported sleep questionaire. In their study, they evaluated patients in three groups; simple partial seizures, complex partial seizures, and generalized seizures, and compared this with a fourth group of controls without seizures. They found that the patients with the most frequent seizures irrespective of the type were those who had the most sleep disturbances. In patients with an associated severe diffuse encephalopathy with their seizure disorder, there was a marked disturbance of the EEG background such that the sleep architecture could not be defined by polysomnography (Besset, 1982; Declerck, 1982).
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