There is a strong association between sleep and epilepsy, which is why at The Insomnia and Sleep Institute of Arizona Dr. Vimala Sravanthi Vajjala specializes in working with patients who have epilepsy. We also work with patients as young as two years old, and although epilepsy can be a disorder anyone struggles with, it often first presents in childhood. The Children’s Hospital Los Angeles just began piloting a new treatment that is a hybrid of a complete 16-channel electroencephalogram (EEG) and overnight polysomnogram (PSG), which is a collaboration between the Division of Neurology and the Division of Pulmonology and Sleep Medicine.
This combined study is only being performed on certain patients in select clinical scenarios. The goal is to make the care more streamlined while minimizing the call for two distinct studies/hospitalizations. Typically, two studies are needed to diagnose epilepsy and sleep-disordered breathing issues, but this approach makes it faster and easier for both patients and their medical teams. According to one of the providers, “Children with epilepsy frequently also have sleep-disordered breathing, such as obstructive sleep apnea, which can increase their risk of seizures.” Of course, having seizures—or worrying about having seizures—can also lead to sleep disorders and this can become a vicious cycle. Epileptic seizures can occur at any time of day or night, but are often common when falling asleep and waking up.
Two-in-One Testing
What makes this pilot so unique is that it seamlessly puts together two very distinct reports and depends on two different specialists to interpret them. A pediatric epileptologist looks at the EEG while a sleep medicine doctor interprets the PSG. This is critical, with one of the providers explaining,
It’s important that both specialists interpret their respective tests. For example, while sleep medicine physicians can recognize clear epileptic discharge patterns on an EEG, for many patients the findings are more subtle and require a robust interpretation from an epileptologist.
At The Insomnia and Sleep Institute, we already combine such specialties for those who are already diagnosed with epilepsy. Understanding the link between sleep and epilepsy is a critical component in managing it. Epilepsy has no cure, but it can be managed, and managing sleep is an important part of that process.
Pilot Program Details
Only children are part of the pilot program at the Epilepsy Monitoring Unit. Each are admitted for 24 – 72 hours, and the sleep study occurs on the first night. This unit holds the highest level of certification, level 4, from the National Association of Epilepsy Centers. At the moment, admission to the pilot program is on a case-by-case basis, requiring an initial examination by the patient’s current pulmonologist, epileptologist, or sleep medicine doctor at the Hospital. One provider in the program stresses,
Not all children with epilepsy need a sleep study. Just having a nocturnal behavior, like sleep walking, is not enough to warrant a polysomnogram. Often, the most urgent matter is ruling out whether the behavior is a seizure, and that can be done with an EEG alone.
The Difficulty of Bidirectional Relationships
Unfortunately, one facet of epilepsy and sleep disorders that is highlighted in this report is the idea that the relationship between epilepsy and sleep is not well understood. “There’s a lot we still need to learn about the relationship between sleep and epilepsy,” says one of the study’s providers. This is true to a degree, but there are also a handful of experts, such as Dr. Vimala Sravanthi Vajjala, whose work focuses specifically on this interplay. “Long-term, these combined studies could potentially help inform research efforts to understand more about certain types of seizures and why they tend to occur during certain stages of sleep,” says one of the study’s researchers. Alternatively, if you struggle with epilepsy and sleep, you could come directly to a world-renowned specialist at this intersection without needing a referral.
Contact The Insomnia and Sleep Institute today to schedule your consultation with Dr. Vimala Sravanthi Vajjala. Call the office during business hours or, for an even quicker response, complete the online contact form now.
