Synergistic effect of sleep depth and seizures correlates with postictal heart rate. (13th March 2021)

• Record Type: Journal Article
• Authors: Schomer, Andrew C.; Lynch, Morgan; Lowenhaupt, Stephanie; Leonardo, Juliana; Baljak, Valentina; Clark, Matthew; Kapur, Jaideep; Quigg, Mark
• Is Part Of: Epilepsia. Volume 62:issue 5(2021)
• Page Start: e65
• Page End: e69
• Publication Date: 2021-03-13
• Subjects: epilepsy -- heart rate -- sleep; Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.16869
• Languages: English
• ISSNs: 0013-9580

Abstract

ABSTRACT: Our objective was to determine the effect of sleep on heart rate following a recorded seizure. We prospectively acquired heart rate data in hospitalized epilepsy monitoring unit patients. We analyzed heart rate trends for multiple seizures ( n = 101) in patients ( n = 42) with electroencephalographically confirmed events. The patient's sleep state was scored for the 5 min preceding each seizure and correlated with the postictal nadir heart rate (PINHR). The depth of sleep during the 5 min before a seizure correlated (correlation coefficient [CC] = −.229, p < .05) with PINHR. This result was more significant and strengthened (CC = −.272, 95% confidence interval = −.392 to −.152, p < .001) when adjusted for covariates of age, generalized tonic–clonic seizures, and baseline heart rate. Sleep depth is an independent predictor of the change in heart rate following a seizure. Diminished heart rate following a seizure in the setting of sleep is likely secondary to non‐rapid eye movement sleep's synergistic effect on parasympathetic tone.