Sleep structure following status epilepticus

OBJECTIVES: To determine the effect of status epilepticus (SE) on sleep. BACKGROUND: SE has a high incidence of morbidity and mortality. The study of sleep structure following SE may have implications for recovery in these patients. METHODS: Twenty-four hour polysomnography was recorded in a 52-year-old patient following generalized convulsive SE not complicated by other medical or neurologic conditions. Another patient with no known history of seizures was recorded under similar conditions. RESULTS: The first day following SE was associated with markedly abnormal sleep structure, consisting largely of stage 1 with minimal slow wave or REM sleep. Over 4 days, slow wave and REM returned to normal values and no rebound was seen. The control patient demonstrated normal sleep parameters for their age, demonstrating that sleep disruption was not due to recording conditions alone. CONCLUSIONS: This case demonstrates that sleep structure is markedly abnormal following generalized convulsive SE. As sleep may serve a restorative function, improving sleep postictally may hasten or improve recovery. Larger studies will be required to determine whether this is a common finding in such patients, and whether outcome is associated with improved sleep quality.