@article{622d27fb0875413682e45f7fab0a8f0e,
title = "Seizure likelihood varies with day-to-day variations in sleep duration in patients with refractory focal epilepsy: A longitudinal electroencephalography investigation",
abstract = "Background: While the effects of prolonged sleep deprivation (≥24 h) on seizure occurrence has been thoroughly explored, little is known about the effects of day-to-day variations in the duration and quality of sleep on seizure probability. A better understanding of the interaction between sleep and seizures may help to improve seizure management. Methods: To explore how sleep and epileptic seizures are associated, we analysed continuous intracranial electroencephalography (EEG) recordings collected from 10 patients with refractory focal epilepsy undergoing ordinary life activities between 2010 and 2012 from three clinical centres (Austin Health, The Royal Melbourne Hospital, and St Vincent's Hospital of the Melbourne University Epilepsy Group). A total of 4340 days of sleep-wake data were analysed (average 434 days per patient). EEG data were sleep scored using a semi-automated machine learning approach into wake, stages one, two, and three non-rapid eye movement sleep, and rapid eye movement sleep categories. Findings: Seizure probability changes with day-to-day variations in sleep duration. Logistic regression models revealed that an increase in sleep duration, by 1·66 ± 0·52 h, lowered the odds of seizure by 27% in the following 48 h. Following a seizure, patients slept for longer durations and if a seizure occurred during sleep, then sleep quality was also reduced with increased time spent aroused from sleep and reduced rapid eye movement sleep. Interpretation: Our results suggest that day-to-day deviations from regular sleep duration correlates with changes in seizure probability. Sleeping longer, by 1·66 ± 0·52 h, may offer protective effects for patients with refractory focal epilepsy, reducing seizure risk. Furthermore, the occurrence of a seizure may disrupt sleep patterns by elongating sleep and, if the seizure occurs during sleep, reducing its quality.",
keywords = "Convulsions, EEG, Electroencephalography, Epilepsy, Long-term, Non-rapid eye movement, Rapid eye movement, Seizures, Sleep, Sleep architecture, Sleep composition, Sleep duration, Sleep quality",
author = "Dell, {Katrina L.} and Payne, {Daniel E.} and Vaclav Kremen and Maturana, {Matias I.} and Vaclav Gerla and Petr Nejedly and Worrell, {Gregory A.} and Lhotska Lenka and Filip Mivalt and Boston, {Raymond C.} and Brinkmann, {Benjamin H.} and Wendyl D'Souza and Burkitt, {Anthony N.} and Grayden, {David B.} and Levin Kuhlmann and Freestone, {Dean R.} and Cook, {Mark J.}",
note = "Funding Information: This research was supported by Australian National Health and Medical Research Council Project Grant 1 130 468 , US National Institutes of Health Grant R01 NS09288203 , Czech Technical University in Prague Grant OHK4 - 026/21 and Epilepsy Foundation of America Innovation Institute, My Seizure Gauge. Funding Information: KD, LK and DG report grant support from the Australian National Health and Medical Research Council. VK, BB and GW reports grant support from the USA National Institutes of Health. VK reports institutional support from Czech Technical University in Prague and National Institutes of Health Brain Initiative. BB reports grant support from the Epilepsy Foundation of America licensed intellectual property for equity in Cadence Neuroscience Inc., patents issued and pending from Mayo Clinic in the field of epilepsy and device supplementation for research purposes by Medtronic Inc. GW reports Mayo Clinic intellectual property for seizure detection, seizure forecasting, sleep, cognition, programmable extracellular vesicles and multiscale electrodes. GW reports royalties from NeuroOne Inc., speaker honoraria from Medtronic Inc. and has licensed intellectual property to NeuroOne Inc. and Cadence Neuroscience Inc. Both GW and the Mayo Clinic have received equity in NeuroOne Inc. related to the licensed intellectual property. GW has performed contract research for Medtronic Inc. WD reports grant support from Eisai Australia and UCB Pharma Global, travel support from UCB Australia, speaker honoraria from Eisai Australia and UCB Pharma Australia, scientific advisory board honoraria from UCB Pharma Australia, Elsai Australia, Liva Nova, and Tilray as well as equity interest in EpiMinder and KeyLead Health. MC reports the position of chair of the SEER Medical board and equity in EpiMinder and SEER Medical. All other authors have no conflicts to report. Publisher Copyright: {\textcopyright} 2021 The Author(s)",
year = "2021",
month = jul,
doi = "10.1016/j.eclinm.2021.100934",
language = "English (US)",
volume = "37",
journal = "EClinicalMedicine",
issn = "2589-5370",
publisher = "Lancet Publishing Group",
}