Composite figure demonstrating the association of ictal type of spike-wave paroxysms with transitory periods between awake and NREM sleep. (A) shows that absences with generalized spike-wave pattern can be elicited by arousing stimulus (calling by name), while the same arousal blocks the pattern by increasing level of vigilance. (B) Schema of the optimal level for absences reachable either by arousal from light sleep or falling asleep. (C) and (D) The distribution of spike-wave activity across the sleep stages. Absence type ictal activation appears exclusively in the transitional periods between awake/NREM and REM/NREM sleep. Attentional awake state usually and REM sleep always block absences. (D) Distribution of absences (indicated by perpendicular lines) across sleep cycles in night sleep in absence epileptic patients.
