According to a new research, which results were published in The Journal of Neurology, people suffering from epilepsy who are sleeping in the prone position are at much higher risk of sudden unexpected death compared with patients who sleep in a different position.
Epilepsy is one of the most common neurological problems. In the United States it affects about 2.3 million adults and 450 000 children. It is a group of vegetative, somatic and psychopathological symptoms. They appear as a consequence of metabolic and morphological abnormalities in the brain. Epileptic seizure is related to the change in the reactivity or the physiological condition of a part or the whole area of the brain. To talk about epilepsy, seizures must be repeatable. The exception are people from the so-called risk group which includes patients after brain injury or a stroke.
Epilepsy is an incurable disease, but seizures can be controlled pharmacologically. Unfortunately, there are cases in which patients do not respond to the treatment. It is chronic, uncontrolled epilepsy. Dr. James Tao from the University of Chicago found that sudden death during sleep is the main cause of death in people with uncontrolled epilepsy. In the studies he and his colleagues have noticed the relationship between the position in which people with epilepsy sleep and the incidence of sudden death.
The researchers analyzed the results of 1106 studies published in the PubMed, Web of Science and Scoupus databases. They took into account 25 studies which described 253 cases of sudden death in patients with epilepsy, in which sleeping position and time of death were documented.
Results of the analysis showed that 73.3% of patients died sleeping in the prone position whereas 26.7% died in a different position.
Also, the scientists distinguished a subgroup of 88 patients in which it was noted that patients under the age of 40 suddenly died in their sleep in the prone position 4 times more often compared with patients over the age of 40. Scientists are still searching for an explanation of this relationship. It is supposed that patients under the age of 40 sleep alone more often because of marital status, what might be a reason that help came too late.
Summing up the results of his analysis, Dr. James Tao came to the conclusion that implementation of the appropriate methods can protect patients from sudden, unexpected death. Patients with epilepsy should consider using special alarm clocks and wristwatches which would identify seizures and announce them through the alarm.
Written by: Katarzyna Gałaszkiewicz, Agata Zwierz, Klaudia Zyzak
Source:
1. Krishnamoorthy E. Treatment of psychiatric disorders in epilepsy. In: The treatment of epilepsy. Shorvon S, et al, eds. Blackwell Science: Oxford, 2004:255–61
2. Association of prone position with sudden unexpected death in epilepsy, James X. Tao, et al., Neurology, published online 21 January 2015
3. Sudden unexpected death in epilepsy, Prof Simon Shorvon, Prof Torbjorn Tomson, .Lancet Volume 378, No. 9808, p2028–2038, 10 December 2011
4. Sleep and Epilepsy, Beth A. Malow, Neurologic Clinics, November 2005 Volume 23, Issue 4, Pages 1127-1147
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