Genetic effects on sleep/wake variation of seizures

Melodie R. Winawer, Jerry Shih, Erin S. Beck, Jessica E. Hunter, Michael P. Epstein

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objective There is a complex bidirectional relationship between sleep and epilepsy. Sleep/wake timing of seizures has been investigated for several individual seizure types and syndromes, but few large-scale studies of the timing of seizures exist in people with varied epilepsy types. In addition, the genetic contributions to seizure timing have not been well studied. Methods Sleep/wake timing of seizures was determined for 1,395 subjects in 546 families enrolled in the Epilepsy Phenome/Genome Project (EPGP). We examined seizure timing among subjects with different epilepsy types, seizure types, epilepsy syndromes, and localization. We also examined the familial aggregation of sleep/wake occurrence of seizures. Results Seizures in nonacquired focal epilepsy (NAFE) were more likely to occur during sleep than seizures in generalized epilepsy (GE), for both convulsive (odds ratio [OR] 5.2, 95% confidence interval [CI] 3.59-7.52) and nonconvulsive seizures (OR 4.2, 95% CI 2.48-7.21). Seizures occurring within 1 h of awakening were more likely to occur in patients with GE than with NAFE for both convulsive (OR 2.3, 95% CI 1.54-3.39) and nonconvulsive (OR 1.7, 95% CI 1.04-2.66) seizures. Frontal onset seizures were more likely than temporal onset seizures to occur during sleep. Sleep/wake timing of seizures in first-degree relatives predicted timing of seizures in the proband. Significance We found that sleep/wake timing of seizures is associated with both epilepsy syndrome and seizure type. In addition, we provide the first evidence for a genetic contribution to sleep/wake timing of seizures in a large group of individuals with common epilepsy syndromes.

Original languageEnglish (US)
Pages (from-to)557-565
Number of pages9
JournalEpilepsia
Volume57
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • Circadian
  • Epilepsy
  • Genetics
  • Seizure
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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    Winawer, M. R., Shih, J., Beck, E. S., Hunter, J. E., & Epstein, M. P. (2016). Genetic effects on sleep/wake variation of seizures. Epilepsia, 57(4), 557-565. https://doi.org/10.1111/epi.13330