Impact of Wearable-detected Sleep Duration, Deprivation, and the Sleep-wake Cycle on Seizure Occurrence in People with Epilepsy
Abstract number :
1.123
Submission category :
2. Translational Research / 2C. Biomarkers
Year :
2022
Submission ID :
2204406
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:24 AM
Authors :
Rachel Stirling, MEng – University of Melbourne; Mark Cook, MD, PhD – University of Melbourne; Wendyl D'Souza, MD, PhD – University of Melbourne; Dean Freestone, PhD – Seer Medical; David Grayden, PhD – University of Melbourne; Cindy Hidajat, BSc – University of Melbourne; Philippa Karoly, PhD – University of Melbourne; Ewan Nurse, PhD – Seer Medical
Rationale: 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 good sleep hygiene. However, emerging evidence paints a more nuanced picture of the relationship between seizures and sleep, with too much and too little sleep both linked to seizure occurrence, and changes in seizure risk closely related to sleep stages and transitions between stages (Dell et al., 2021). We conducted a longitudinal study investigating sleep and self-reported seizure occurrence in an ambulatory setting using mobile and wearable monitoring. The study aimed to identify whether a relationship existed between sleep duration, oversleep, undersleep, or sleep/wake times and seizure occurrence.
Methods: Forty-four subjects wore a Fitbit wearable device for at least 30 days while reporting their seizure activity in a mobile app. Numerous sleep features – sleep duration, oversleep and undersleep, and sleep onset and offset times – were investigated prior to seizure occurrence. Participants with at least 10 seizure days (N=29) were included in seizure analyses.
Results: A total of 3894 reported seizures (M = 88, SD = 130) and 17078 recorded sleep nights (M = 388, SD = 351) were included in the study. Epilepsy participants slept 22 minutes longer, on average, compared to the general population. 3 of 29 (10%) participants showed a significant difference in sleep duration the night before seizure days compared to seizure-free days, and five of 29 (17%) participants displayed a significant sleep duration trend on the week leading up to seizure days (Figure 1). Eleven of 29 (38%) subjects also showed significant differences between either their sleep onset or offset times on seizure days compared to seizure-free days (Figure 2). We also found oversleeping was significantly associated with increased seizure risk in the following 48h, and nocturnal seizures increased this risk. Most participants had at least one seizure-sleep relationship; but trends were unique to the individual.
Conclusions: These results demonstrated that day-to-day sleep duration shows a weak association with reported seizures in a small subset of individuals, however monitoring bed- and wake-times is more useful to predict seizure risk the following day. Oversleeping is also linked to seizures, most likely due to nocturnal seizures. Wearables can be utilised to identify this sleep-seizure relationship and guide clinical recommendations or improve seizure forecasting algorithms.
Funding: Not applicable
Translational Research