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 wo rk has shown that sleep deprivation of any type can exacerbate seizure acti vity, leading to speculation that the intrinsically poor sleep in these pat ients 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 sle ep 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 compa re studies of normal controls, which have only rarely been accomplished, wi th studies of drug-free patients, which are difficult to achieve. As little as is known about the detailed effects of AEDs on sleep architecture, et e n less is known about the mechanisms by which AEDs might cause such effects . Nevertheless, there is great potential for those undertaking such work, d ue to the wealth of basic science accumulating in the field of sleep mechan isms and the prodigious amount of information already amassed in the area o f anticonvulsant mechanisms.