THE INTERRELATIONSHIP OF EPILEPSY, SLEEP DISORDERS, AND ANTIEPILEPTIC THERAPY

Relevance. Epilepsy and sleep disorders are comorbid conditions combined by complex bidirectional pathophysiological relationships. Sleep disorders in patients with epilepsy often go undiagnosed, and existing reviews rarely integrate data on the role of antiepileptic drugs in modulating this relationship.

Aim. To systematize and actualize the results of modern clinical and preclinical studies on the relationship between the mechanisms of epilepsy and sleep disorders, to evaluate the role of antiepileptic in modulating these processes, and to justify the need for expanding diagnostic approaches.

Materials and Methods. A literature search was conducted in PubMed, Google Scholar, eLibrary.ru, and CyberLeninka databases for the period from 2016 to 2026. Inclusion criteria were original research and systematic reviews in Russian and English covering epilepsy, sleep disorders, and the pharmacology of antiepileptic drugs. Search queries included relevant keyword combinations. After the selection procedure, 40 eligible publications were chosen for analysis.

Results. The analysis confirmed a bidirectional relationship between sleep and epilepsy: sleep deprivation and fragmentation of its structure act as powerful triggers of seizures, while interictal epileptiform activity and seizures themselves disrupt the architecture of sleep. Different classes of antiepileptic drugs have different effects on the sleep-wake cycle: they normalize the structure of sleep by suppressing epileptiform activity, or excessively depress the REM sleep phase and cause daytime sleepiness.

Conclusion. The choice of antiepileptic therapy should be carried out taking into account the chronobiological profile of the drug and an individual assessment of the patient's sleep characteristics. The presented review highlights the problem of dissomnia disorders in patients with epilepsy through the prism of the pharmacodynamics of antiepileptic drugs, and assesses the relationship between various forms of epilepsy and their characteristic sleep disorders. Understanding the mechanisms linking epilepsy and sleep will help improve seizure control and improve the quality of life for patients with epilepsy.

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