Sleep Disruption in Epilepsy

Epilepsy is the fourth most common neurological disorder and affects people of all ages of which the hallmark is recurrent seizures. A seizure is a sudden surge of electrical activity in the brain. The electrical activity is caused by chemical changes that occur in nerve cells; in the case of epilepsy there is either too much or too little activity occurring at the level of synapses that leads to this surge of electrical activity. People with epilepsy may experience academic, cognitive, and behavioral complications that are a result of recurrent seizures or side effects of anti-epileptic medications themselves. 

            As a college student managing this condition I have to be more careful than the average person that my physiology remains in balance. Seizures can be triggered by a variety of things including stress, disruption in circadian rhythm, improper use of medication or other substances, and even what you eat. I recently found a paper detailing how sleep disruption can cause cognitive impairment and resulting decrease in academic performance.  There were four factors of sleep disturbance that were analyzed in the paper: sleep disturbance as a result of sociocultural factors, the presence of specific sleep disorders such as REM behavior disorders, interference of epileptiform activity and seizures upon sleeping, and positive and/or negative effects of anti-epileptic drugs on sleep (Parisi, et.al, 2010). Patients with epilepsy are at greater risk for sleep fragmentation and higher proportions of wakefulness and light sleep even if the individual does not experience nocturnal seizures.

            There is much evidence that sleep is very important in memory formation and cognitive performances. Studies have shown that in individuals with impaired REM sleep also have impaired memory. In individuals with epilepsy even sub-clinical epileptic discharges during sleep may disrupt cognitive function due to the disruption of sleep. Prolonged focal epileptic activity during sleep would interfere with nREM and REM sleep physiology, this imparting the individual’s learning process and plastic changes associated with learning. (Parisi et. Al, 2010)

            As a fifth-year science major I am always trying to get the most sleep possible and keep my circadian rhythm in balance which is a colossal task given the demands of a college education. I have always been told lack of sleep is a potential trigger for seizures. Reading this article brings to light how much disadvantage those with epilepsy are at in the sleep category compared to a person with normal brain physiology. Not only must I balance my circadian rhythm, but epilepsy itself may be impairing my sleep and my resulting learning process. The question this raises for me is if individuals with epilepsy are at a greater academic disadvantage to start with, what can a school and that individual do to ensure the best environment for learning possible? The only answer science has at the moment: take your medication and avoid seizure triggers to have the best control of your epilepsy possible. 

Parisi, P., Bruni, O., Pia Villa, M., Verrotti, A., Miano, S., Luchetti, A., & Curatolo, P. (2010). The relationship between sleep and epilepsy: the effect on cognitive functioning in children. Developmental Medicine & Child Neurology, 52(9), 805-810.