Einfluss von Schlafentzug auf die Schlafarchitektur bei Menschen mit Epilepsie

Korell, Marie

Thesis

Open Access

Einfluss von Schlafentzug auf die Schlafarchitektur bei Menschen mit Epilepsie

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Date

2025-11-24

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Korell, Marie

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Person

Straube, Benjamin

Abstract

This prospective clinical study was able to demonstrate the effect of sleep deprivation on the sleep architecture in people with epilepsy. As expected, the proportion of deep sleep and recovery sleep (sleep stage N3) increased significantly due to the sleep deprivation. In addition, sleep deprivation significantly shortened sleep latency, latency to sleep stage N2 and sleep stage REM due to the increased sleep pressure. Contrary to expectations, there was no significant change in sleep efficiency and no significant decrease in the proportion of sleep stages N2 and REM, which suggests that our patients' sleep quality was not impaired by sleep deprivation. With unchanged awakening and arousal indices and a significantly shortened time in the “awake after initial sleep onset” (WASO) stage, there is also no evidence of increased sleep fragmentation due to sleep deprivation. We were also able to reproduce the effect of sleep deprivation on the increased risk of epileptic seizures, which has been adequately described in the literature. In the control cohort, there was no significant change in sleep architecture due to sleep deprivation. However, a MANOVA could not detect any interaction effects between the independent variables cohort (epilepsy and control) and sleep deprivation with regard to the dependent variables sleep efficiency and the proportions of N1, N2, N3 and REM in the total sleep time. Due to the small number of cases, the focus on pre-surgical patients in the epilepsy cohort and the mentally unwell control cohort, neither cohort appears to be a fully representative sample overall, which means that the results have no external validity for the entire target population of all people with epilepsy. A differentiation of the effect of sleep deprivation with regard to different demographic conditions, localizations, aetiology or epilepsy syndromes is not possible due to the small number of cases. In addition, comparability with other studies is severely limited, as sleep deprivation was not standardized. The first-night effect is not taken into account in our study. The external conditions of the study and the superimposition of some effects (sleep deprivation, medication reduction, etc.) could influence our results. Larger studies with more specific study protocols should be conducted in order to be able to use sleep deprivation in VEM more specifically as a diagnostic tool and to be able to make individual recommendations regarding sleep behavior (e.g. shift work). The establishment of a standard PSG should not only be carried out in cases of refractory epilepsy, but as a standard for initial diagnosis and as a follow-up for people with epilepsy. At the same time, the effect of long-term seizure-suppressive medication on sleep quality should be checked regularly so that adjustments can be made if necessary. This can improve the cognitive and physical performance and ultimately the satisfaction and quality of life of people with epilepsy.