Effect of anticonvulsants on sleep.

The intensive study of seizures via serial 24-hour EEG-video monitoring has allowed enhanced observation of sleep patterns among epilepsy patients and has revealed that disturbed rest is common in this population. Previous work has shown that sleep deprivation of any type can exacerbate seizure activity, leading to speculation that the intrinsically poor sleep in these patients may serve as a threshold-lowering factor, and that this factor might be partially reversed by effective antiepileptic drugs (AEDs). However, to better understand this interaction, it is necessary to know whether the sleep disorder of epilepsy is caused by repetitive ictal events or whether it is part of a process that causes epilepsy to emerge in the first place. In addition, to separate and analyze the sleep effects of AEDs, one must compare studies of normal controls, which have only rarely been accomplished, with studies of drug-free patients, which are difficult to achieve. As little as is known about the detailed effects of AEDs on sleep architecture, even less is known about the mechanisms by which AEDs might cause such effects. Nevertheless, there is great potential for those undertaking such work, due to the wealth of basic science accumulating in the field of sleep mechanisms and the prodigious amount of information already amassed in the area of anticonvulsant mechanisms.