New Research Sheds Light on the Link Between Sleep and Sudden Unexpected Death in Epilepsy (SUDEP)

31st May 2021

Researchers from the University of Virginia School of Medicine have discovered a new potential link between sleep and SUDEP. It’s long been known that people with epilepsy are at a higher risk of SUDEP, but very little is known about why this is the case. 

The research was conducted by monitoring the sleep of 41 people with epilepsy and recorded 101 sleep seizures to look for commonalities. The patients were recorded between February 2018 and August 2019. Each patient was 17 or older and had a median age of 40.5. 

It was found that the combination of sleep and a seizure could work together to lower the heart rate to potentially serious levels, and in some tragic cases causing Sudden Unexpected Death in Epilepsy (SUDEP). 

Speaking about the research,  Andrew Schomer, MD, of UVA’s Department of Neurology and the UVA Brain Institute commented: “We have been trying to better understand the cardiac changes around the time of a seizure in patients with epilepsy. When we looked at the heart rates for patients with epilepsy admitted to the hospital, many of them develop tachycardia [a fast heart rate] following a seizure, but a subset of patients have a decreased heart rate. This decline was more pronounced when the patients were asleep,” 

“The mechanism of SUDEP, or Sudden Unexpected Death in Epilepsy, is still not fully understood. We know there is an increased risk during sleep and if seizures are poorly controlled. Hopefully with further study we can try to identify individuals who are at an increased risk and work to prevent this devastating outcome.”

The heart rate is naturally decreased during deep sleep, and the research showed that in some cases when a seizure occurred during sleep this caused the heart rate to speed up. However, the greater the sleep depth prior to the seizure, the more likely it was that the heart rate was likely to decrease. The effect of the seizure is secondary to this natural slowing of the heart rate that everyone has during deep sleep patterns. 

More research is still needed to fully understand SUDEP so that the risk can be minimised, although hopefully this research will go a long way. Researchers have estimated that 1 in every 1,000 people with epilepsy could die from SUDEP. 

“People with poorly controlled seizures have the greatest risk of SUDEP, and seizures during sleep may hold the higher risk,” said Quigg, of UVA’s Department of Neurology and the UVA Brain Institute. “Our findings can direct further research to determine how the heart’s and lung’s control systems fail during sleep-related seizures in order to help prevent SUDEP.”

There have been recent high profile cases of SUDEP, with actor and Disney star Cameron Boyce tragically losing his life. In addition, a recent viral Twitter thread raised over £100K in aid of Amelia Roberts who also sadly lost her life to SUDEP. 

This research was published in the scientific journal Epilepsia by a research team consisting of Schomer, Morgan Lynch, Stephanie Lowenhaupt, Juliana Leonardo, Valentina Baljak, Matthew Clark, Jaideep Kapur and Quigg. 

We’ve written in more detail about sleep and epilepsy before, click here to read our previous blog post.  

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