Insufficient sleep, EEG activation, and seizure risk: Re-evaluating the evidence.

Insufficient sleep has been considered a seizure trigger in people with epilepsy for thousands of years. Here, we reviewed the evidence upon which this axiomatic association might be predicated. After evaluating evidence suggesting insufficient sleep as an EEG activator, we systematically reviewed the literature for longitudinal studies measuring the effect of insufficient sleep on seizure risk. Ultimately, published works designed to prove a causal relationship were of low level of evidence and disagreed with one another. Despite the idea's deep-seated nature, when considering causal evidence only, no conclusion can be made regarding the relationship between insufficient sleep and seizure risk. This article is protected by copyright. All rights reserved.