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The Relationship Between Sleep, Epilepsy, and Development: a Review

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Putative roles for homeostatic plasticity in epileptogenesis

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Summary: Homeostatic plasticity allows neural circuits to maintain activity levels and learn new associations, but can also contribute to seizures in certain conditions. Understanding the active homeostatic mechanisms in different stages of development and circuits can help target therapies and disrupt the cycle of recurring seizure clusters.

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Does sleep correlate with neurodevelopmental outcomes in preterm and term infants in early-preschool children?

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Functional roles of REM sleep

Yasutaka Mukai et al.

Summary: Rapid Eye Movement (REM) sleep is a mysterious and fascinating sleep state characterized by unique brain activity and reduced muscle tone. While various physiological phenomena occur during REM sleep, it is still unclear whether they are the causes or consequences of REM sleep.

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Sleep architecture in drug-naive adult patients with epilepsy: Comparison between focal and generalized epilepsy

Carmen Calvello et al.

Summary: Objective: To evaluate sleep structure in drug-naive people with epilepsy (PWE) and compare it with controls. Results: Sleep quality, continuity, and stability were impaired in PWE, leading to a reduction in REM sleep.

EPILEPSIA OPEN (2023)

Article Behavioral Sciences

Encephalopathy related to status epilepticus during slow sleep (ESES) Pathophysiological insights and nosological considerations

Guido Rubboli et al.

Summary: Encephalopathy related to Status Epilepticus during slow Sleep (ESES) is a childhood epilepsy syndrome characterized by cognitive, behavioral, and motor disturbances, along with abnormal brain activity during non-REM sleep. The pathophysiological mechanisms underlying this condition are not fully understood. Summary rating: 7/10

EPILEPSY & BEHAVIOR (2023)

Article Clinical Neurology

Focal epilepsy impacts rapid eye movement sleep microstructure

Katharina Schiller et al.

Summary: The study found that patients with focal epilepsy, especially extratemporal lobe epilepsy, show a global reduction in STW activity during REM sleep. This suggests that epilepsy can affect cortically generated sleep oscillations even in REM sleep when epileptic activity is low.
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Sleep and seizure risk in epilepsy: bed and wake times are more important than sleep duration

Rachel E. Stirling et al.

Summary: Bed and wake times are more crucial than sleep duration in identifying seizure risk for people with epilepsy. Undersleeping is associated with a slight decrease in seizure risk, possibly due to nocturnal seizures. Wearables can be used to analyze sleep-seizure relationships and provide clinical recommendations.
Review Clinical Neurology

Sleep in children with refractory epilepsy and epileptic encephalopathies: A systematic review of literature

R. Proost et al.

Summary: Children with epilepsy are more prone to sleep disorders, and disruption of sleep architecture may affect cognitive development. Sleep disruption could be an important contributing factor to the severity of cognitive impairment in children with drug-refractory epilepsy. Further research is needed to better understand the interactions between epilepsy and sleep, particularly in children with drug-refractory epilepsy and epileptic encephalopathies.

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Reduced REM sleep: a potential biomarker for epilepsy - a retrospective case-control study

Ufuk Sadak et al.

Summary: This study found a significant decrease in REM sleep percentage in individuals with epilepsy. REM%-based models showed good predictive performance and could improve diagnostic accuracy for epilepsy.

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Review Clinical Neurology

Sleep architecture in neonatal and infantile onset epilepsies in the first six months of life: A scoping review

Sangeeta Jethwa et al.

Summary: This scoping review examined sleep architecture in infants and neonates with epilepsy. The findings suggest that sleep architecture is generally preserved in self-limited familial epilepsy but significantly disrupted in developmental and epileptic encephalopathies (DEEs) and epilepsy with genetic or structural etiology. Early identification of infants with epilepsy is crucial for timely treatment, and further research is needed to understand the relationship between abnormal brain development, epilepsy, and sleep disruption.

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Characterizing Sleep Phenotypes in Children With Newly Diagnosed Epilepsy

Temitayo Oyegbile-Chidi et al.

Summary: This study finds that there are three distinct sleep disturbance phenotypes in children with newly diagnosed epilepsy, namely minimal sleep disturbance, moderate sleep disturbance, and severe sleep disturbance. These phenotypes are associated with the age of onset, cognitive performance, and emotional-behavioral problems of the patients.

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The Interaction Between Sleep and Epilepsy

Annie H. Roliz et al.

Summary: This review covers the mutual interactions between sleep and epilepsy, mechanisms of epileptogenesis in sleep, the relationship between sleep apnea and epilepsy, and potential strategies to treat seizures. Recent studies have emphasized the role of functional network systems underlying epileptiform activation in sleep in various epilepsy syndromes, and new treatment approaches including chronotherapy and seizure monitoring devices are being explored. Adenosine kinase and orexin receptor antagonists are promising new drug targets for seizure treatment.

CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS (2022)

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Focal epilepsy disrupts spindle structure and function

Katharina Schiller et al.

Summary: This study investigated the impact of epilepsy on sleep spindles and their relation to cognitive function. The results showed that patients with epilepsy had lower global spindle rates during sleep compared to healthy controls. Furthermore, spindle rates were reduced in the region of the epileptic focus and this reduction was associated with impaired attention. These findings suggest that sleep spindles may play a role in cognitive functioning in patients with epilepsy.

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Sanna Lokhandwala et al.

Summary: Sleep plays a crucial role in brain and cognitive development, especially during infancy and early childhood. Research suggests that there are parallel changes in sleep and the brain during development, and they have a bidirectional relationship.

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Current ideas about the roles of rapid eye movement and non-rapid eye movement sleep in brain development

Marit S. Knoop et al.

Summary: Understanding the relationship between sleep and brain development is crucial, as REM sleep and NREM sleep play different roles in various aspects of brain maturation. Research suggests that sleep problems can have different consequences on the developing brain, depending on the age of the individual. A hypothetical model has been proposed to illustrate the dynamic relationship between REM sleep, NREM sleep, and brain maturation processes, providing implications for neonatal care practices and future research directions.

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Is the glymphatic system the missing link between sleep impairments and neurological disorders? Examining the implications and uncertainties

Jennaya Christensen et al.

Summary: The glymphatic system is a recently discovered waste clearance system for the central nervous system, with important implications for neurological disorders. There is currently controversy regarding key aspects of this novel system, including its structure and function, which require further research to elucidate.

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Sleep disruption in children and adolescents with epilepsy: A systematic review and meta-analysis

Alice A. Winsor et al.

Summary: This study found significant differences in sleep time, quality, and sleep problems between children with epilepsy and healthy children. Children with epilepsy experienced reduced sleep time, more sleep difficulties, increased N2 sleep, and decreased sleep efficiency compared to healthy children. Screening for sleep problems is essential in the diagnosis of epilepsy to ensure proper identification and treatment of clinically relevant sleep issues.

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Rapid eye movement sleep disturbance in patients with refractory epilepsy: A polysomnographic study

Wei-Chih Yeh et al.

Summary: Patients with refractory epilepsy exhibited more disrupted REM sleep compared to those with medically controlled epilepsy. There were no significant differences in other sleep parameters and the prevalence of OSA between the two groups. This study suggests that patients with refractory epilepsy may be less susceptible to OSA.

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Seizure likelihood varies with day-to-day variations in sleep duration in patients with refractory focal epilepsy: A longitudinal electroencephalography investigation

Katrina L. Dell et al.

Summary: Seizure probability changes with day-to-day variations in sleep duration, with an increase of 1.66 hours in sleep duration leading to a 27% decrease in seizure odds. Following a seizure, patients slept longer and experienced reduced sleep quality if the seizure occurred during sleep.

ECLINICALMEDICINE (2021)

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Behavioral-state development and sleep-state differentiation during early ontogenesis

Emilie Bourel-Ponchel et al.

Summary: Sleep plays a crucial role in neurodevelopment, and premature birth can disrupt sleep maturation, affecting the quality of neurodevelopment. Monitoring sleep quality in newborns is important for early detection of neurodevelopmental disorders.

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Homeostatic Plasticity in Epilepsy

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REM sleep promotes experience-dependent dendritic spine elimination in the mouse cortex

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A combined astrocyte - G-lymphatic model of epilepsy initiation, maintenance and termination

Avinoam Rabinovitch et al.

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Neonatal Sleep-Wake Analyses Predict 18-month Neurodevelopmental Outcomes

Renee A. Shellhaas et al.

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Sleep architecture in patients with Juvenile Myoclonic Epilepsy

Jaidaa F. Mekky et al.

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Neonatal Sleep-Wake Analyses Predict 18-month Neurodevelopmental Outcomes

Renee A. Shellhaas et al.

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Sleep recalibrates homeostatic and associative synaptic plasticity in the human cortex

Marion Kuhn et al.

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Impact of sleep duration on seizure frequency in adults with epilepsy: A sleep diary study

Maurine M. Cobabe et al.

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The Glymphatic System: A Beginner's Guide

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Impairment of Glymphatic Pathway Function Promotes Tau Pathology after Traumatic Brain Injury

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Excitotoxicity: Bridge to various triggers in neurodegenerative disorders

Ankita Mehta et al.

EUROPEAN JOURNAL OF PHARMACOLOGY (2013)

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Sleep Drives Metabolite Clearance from the Adult Brain

Lulu Xie et al.

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High STOP-Bang score indicates a high probability of obstructive sleep apnoea

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BRITISH JOURNAL OF ANAESTHESIA (2012)

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The impact of epilepsy on sleep architecture during childhood

Alessandra M. Pereira et al.

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Markedly disturbed sleep in medically refractory compared to controlled epilepsy - A clinical and polysomnography study

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Erasing Synapses in Sleep: Is It Time to Be SHY?

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EEG Sleep Slow-Wave Activity as a Mirror of Cortical Maturation

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Sleep and waking modulate spine turnover in the adolescent mouse cortex

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Sleep and Synaptic Homeostasis: Structural Evidence in Drosophila

Daniel Bushey et al.

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