Relationship between sleep and seizures

Sleep duration, sleep deprivation and the sleep-wake cycle are thought to play an important role in the generation of epileptic activity and may also influence seizure risk.

Hence, people diagnosed with epilepsy are commonly asked to maintain consistent sleep routines.

However, emerging evidence paints a more nuanced picture of the relationship between seizures and sleep, with bidirectional effects between changes in sleep and seizure risk in addition to modulation by sleep stages and transitions between stages.

In this new investigation the authors (Brain, awac476, https://doi.org/10.1093/brain/awac476) conducted a longitudinal study investigating sleep parameters and self-reported seizure occurrence in an ambulatory at-home setting using mobile and wearable monitoring.

Sixty subjects wore a Fitbit smartwatch for at least 28 days while reporting their seizure activity in a mobile app. Multiple sleep features were investigated, including duration, oversleep and undersleep, and sleep onset and offset times.

Overall, the presented results demonstrated that day-to-day changes in sleep duration had a minimal effect on reported seizures, while patient-specific changes in bed- and wake-times were more important for identifying seizure risk the following day.

Nocturnal seizures were the only factor that significantly increased the risk of seizures in the following 48 h on a group level.

Nocturnal seizures were associated with both significantly longer sleep durations and increased risk of a seizure occurring in the following 48 h.

Wearables can be utilised to identify these sleep-seizure relationships and guide clinical recommendations or improve seizure forecasting algorithms.

Source: Brain