Patients are more likely to die of sudden unexpected death in epilepsy (SUDEP) while they are asleep, according to a review of over 1000 SUDEP cases gleaned from 67 studies.
- Among 1025 patients with SUDEP, 880 cases had a circadian pattern.
- Of the 880 cases with a circadian pattern, 69.3% of the deaths occurred during sleep and 30.7% while patients were awake ( P<0.001).
- Subgroup analysis found 272 patients in which both circadian pattern and age could be established.
- In this subgroup, patients aged 40 years and younger were more likely to die while asleep, when compared with older patients (odds ratio, 2.0).
- Among patients whose body position could also be verified, prone position was more often associated with death, when compared with those in prone position who were awake (87.6% vs 52.9%).
Ali A, Wu S, Issa NP, et al. Association of sleep with sudden unexpected death in epilepsy. [Published online ahead of print September 13, 2017] Epilepsy Behav. https://doi.org/10.1016/j.yebeh.2017.08.021