Epilepsies et sommeil : la place du somnologue

Relationships between sleep and epilepsy are complex because sleep has a dual property in epilepsy : it can be either protective or precipitating. In this paper, we describe the effect of sleep on epilepsy, the repercussion of epilepsy on sleep and the place of the somnologist in the management of the patient. He is the one who prescribes video sleep recordings (with the correct setting). He must know the nocturnal manifestations of the seizure to establish a positive diagnosis of epilepsy and to differentiate seizures from parasomnias. He must recognize specific interictal activity. He can often precise a focalisation and establish anatomical and clinical correlations. He is able to advise antiepileptic medications. At last he can diagnose other sleep pathologies such as sleep apnea syndrome which can worsen the epilepsy by different mechanisms.The treatment by nasal CPAP allows a better control of seizure frequency.