Im guessing the fact that blood levels of the meds are at their lowest at that time also plays a part. From the reading, sleep apnea can cause seizures. Ongoing research is necessary to fully elucidate the pathophysiology of these disorders, which share a host of clinical manifestations. My nocturnal seizures also seem to be in the 2am to 7am time period. VPSG-EEG is indicated in the evaluation of patients with complex nocturnal behaviors when routine EEG is nondiagnostic. The diagnosis of complex nocturnal behaviors is among the most difficult to establish in sleep medicine clinics and laboratories. This procedure provides improved detection of interictal and ictal EEG abnormalities and time-synchronized correlation of clinical and neurophysiologic phenomena. VPSG-EEG combines PSG with comprehensive EEG to evaluate unexplained nocturnal behaviors when epileptic seizures are suspected. The high prevalence of parasomnias in NFLE families further confounds their distinction. They may also characterize some frontal or temporal nocturnal seizures of sleep-related hypermotor epilepsy, or be considered. A dysfunctional arousal mechanism involving the cholinergic system is involved in the pathophysiology of the autosomal dominant form of NFLE and NREM parasomnias. Rhythmic movements during sleep may occur in the context of physiological sleep-related motor activity or be part of sleep-related movement disorders such as bruxism, periodic limb movement disorder, restless legs syndrome, and sleep-related rhythmic movement disorder. Video polysomnography with EEG (VPSG-EEG) has identified key clinical features useful in differentiating these disorders. Seizures in NFLE have a wide range of complexity and severity, overlapping considerably with the disorders of arousal from non-REM (NREM) sleep. While the differential diagnosis of sleep-related movements, including physiologic and pathologic phenomena, is extensive, the focus of evaluation in patients with complex nocturnal behaviors distinguishes between nocturnal seizures and parasomnias. ![]() The evaluation and treatment of patients with complex nocturnal behaviors can be challenging. This article summarizes the clinical and electrophysiologic manifestations of nocturnal seizures, particularly nocturnal frontal lobe epilepsy (NFLE), parasomnias, and other disorders presenting with complex behaviors in sleep.
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