Sleep-related disruptions potentially synergistically exacerbate attentional impairments in temporal lobe epilepsy, especially the alerting network.

Aim: To explore the potential synergistic effect of sleep-related disruptions (SRD) on attention dysfunction in temporal lobe epilepsy (TLE), focusing on how SRD impacts specific attention networks, including alertness, orientation, and executive control.

Methods: Ninety-three patients with TLE and matched healthy controls participated. Attention was assessed using the Attention Network Test (ANT) and eye-tracking data, while SRD severity was determined via the Pittsburgh Sleep Quality Index. Participants were categorized based on SRD severity, and attention performance across the three networks was evaluated.

Results: Patients with TLE demonstrated significant attention impairments, predominantly affecting the alertness and executive control networks. SRD aggravated these deficits, particularly in the alertness network, with more severe SRD correlating with greater dysfunction. Moderate to severe SRD led to significant declines in alertness, while minimal SRD showed no substantial impact on attention performance.

Conclusion: SRD exacerbates attention dysfunction in patients with TLE, particularly within the alertness network. These findings highlight the critical role of sleep quality in managing cognitive function in TLE and suggest early intervention for patients with significant SRD to improve outcomes.