SANP Swiss Archives of Neurology, Psychiatry and Psychotherapy 2297-7007 2297-6981 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 03231 10.4414/sanp.2021.03231 Invited review article Sleep disorders The mutual interaction between sleep and epilepsy Imbach Lukas lukas.imbach@kliniklengg.ch Medical Director | Frauenklinikstrasse 26 | Zurich | Zürich | SWITZERLAND Capecchi Francesco francesco.capecchi@usz.ch University Hospital Zurich, Zurich Switzerland 01 11 2021 173 06 0 0 Copyright: EMH Schweizerischer Ärzteverlag AG 2021 EMH Schweizerischer Ärzteverlag AG "Swiss Archives of Neurology, Psychiatry and Psychotherapy" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing.

The complex relationship between epilepsy and sleep has been early recognized based on behavioral studies showing that most epileptic seizures occur during sleep. In particular, during NREM (slow wave) sleep, neuronal circuits oscillate between their active and inactive state, facilitating epileptic discharges. Conversely, epileptic activity during sleep can disrupt the physiologic sleep microstructure and sleep architecture causing sleep deprivation and daytime sleepiness, which further enhances the seizure probability. Besides this mutual interaction, the clinical differentiation between epileptic and non-epileptic events during sleep can be very challenging. In this article, we aim to give an overview of the intertwined relationship between sleep and epilepsy, discuss the differential diagnosis between epileptic and non-epileptic nocturnal episodes and give insights to novel techniques of sleep modulation to treat epilepsy.