Epilepsy and Sleep

Epilepsy is one of the most common neurological disorders, characterized by spontaneous and recurring unprovoked seizures, affecting approximately at least 2% of the global population. Epileptogenesis involves complex and dynamic changes at the molecular, cellular, and network levels within the brain. A critical aspect of this process is the reorganization of neuronal networks, which plays an essential role in the development and perpetuation of epileptic activity. This reorganization includes alterations in synaptic connectivity, neurogenesis, and the balance between excitatory and inhibitory neurotransmission. The relationship between sleep and epilepsy is complex and bidirectional. Sleep can influence seizure occurrence and interictal epileptiform discharges (IEDs), and conversely, epilepsy and seizures can impact sleep architecture and quality. Insomnia in children with epilepsy is a complex and multifactorial condition involving intricate interactions between neurophysiological, genetic, psychological, and environmental factors. Understanding the pathophysiol- ogy of insomnia in this population requires a comprehensive approach considering the diverse mechanisms contributing to sleep disruption.