Sleep-Deprived EEGs Best for Studying Epilepsy

By Adam Modzelesky
EpilepsyUSA staff
Posted: December 9, 2004

It is no secret that lack of sleep can cause seizures. Because of this, it's important to study the effects of sleep deprivation and according to Nathan Fountain, M.D., there is nothing better than using a sleep-deprived EEG.

Fountain, an associate professor at the University of Virginia who spoke at an American Epilepsy Society conference meeting recently, said that sleep activates epileptiform discharges. In a recent study of 29 people, 52 percent demonstrated activation of these discharges during a sleep-deprived EEG.

In past years, regular EEGs have been used in similar studies and some came back showing no activation - something Fountain considers highly suspect.

In conjunction with Fountain's data suggesting sleep-deprived EEGs are more effective for studying epilepsy, he also presented data that suggests many of today's general neurologists are not fully aware of the procedure's methodology. Therefore, they are less inclined to prescribe the test to their patients. Only one-in-15 general neurologists will prescribe a sleep-deprived EEG as the patient's first EEG.

Another point of interest from Fountain's lecture was the ongoing debate arguing which is better: sleep-deprived EEGs or drug induced EEGs. Fountain reported that 11 studies were done on this subject. Eight came back with "inconsistent results," and three reported that sleep-deprived EEGs provide better results.

Fountain concluded his presentation by outlining the ways a person can have a seizure due to sleep deprivation: having a sleep disorder, antiepileptic drugs and poor sleeping patterns. He said that patients should use their common sense when making decisions that might affect their health, and that they should make sure they get enough sleep.

Maintaining Consistent Circadian Rhythms Important

Also addressed at the conference session was the importance of a person with epilepsy either maintaining, or gradually adjusting his or her circadian rhythms so a seizure does not occur.

A person's body has over 100 circadian rhythms, and they are the body's 24-hour cycles which influence the body's functions, including body temperature, hormone levels, heart rate, blood pressure and even pain threshold.

According to Mark Quigg, M.D., also an associate professor from the University of Virginia, a person, particularly a person with epilepsy, needs to give his or her body enough time to adjust to new sleeping patterns. A period of adjustment is gradual and might take as long as a week, depending on how drastic the change.

A real-life example demonstrating the importance of Quigg's message was recently reported in the news. Timothy Monk, Ph.D., recently reported that the human body has more difficulty adjusting to different sleep times than initially thought.

Monk, a professor from the University of Pittsburgh Medical Center, did his study for NASA and his results were recently published in the December 2004 issue of Aviation, Space and Environmental Medicine. His study focused on how long astronauts should be given to adjust their sleeping cycles while in space. Monk and his team of researchers also found that people should exercise patience and adjust their circadian rhythms gradually.

According to Monk's study, the body only adjusts itself by about one hour each night. Therefore, people who need to adjust their circadian rhythms should go to bed only one hour later than normal.

Like Fountain and Quigg, Monk also reported ways to best maintain good health. According to Monk, it's in everybody's interest to: Go to bed as soon as possible after a night shift, make rooms as dark and quiet as possible while sleeping, use caffeine sensibly and avoid using alcohol before sleep.