Sleep macro‐architecture in sleep‐deprivation–sensitive and sleep‐deprivation–insensitive juvenile myoclonic epilepsy: A polysomnographic study
Sujata Roshan, Manvi LambaAbstract
Objective
Sleep deprivation (
Methods
Overnight polysomnography was done in healthy volunteers ( n = 30), JME patients without SD‐triggered seizures (SD‐insensitive, n = 31), and JME patients reporting SD‐triggered seizures on a structured interview (SD‐sensitive, n = 68). Eleven participants with clinically diagnosed narcolepsy were excluded. We analyzed sleep continuity, stage distribution, rapid eye movement (REM)/non‐REM (NREM) stability, and cardiorespiratory indices.
Results
SD‐insensitive patients had lower sleep efficiency than controls but preserved stage N3 and REM. SD‐sensitive patients had significantly lower N3 than SD‐insensitive patients ( p = .002) and reduced REM vs controls ( q = .005). SD‐sensitive status independently predicted N3% after adjusting for sex and anti‐seizure medication class ( β = −8.28, p = .013), and remained significant after further adjustment for generalized tonic–clonic seizure (GTCS) frequency ( β = −7.35, p = .035). Valproate use was also independently associated with N3 reduction ( β = −8.37, p = .007). Respiratory and cardiac indices did not differ.
Significance
SD‐sensitive JME shows a light NREM‐dominant sleep profile with decreased N3 vs SD‐insensitive patients along with decreased REM when compared to controls. These differences are associative (SD sensitivity was self‐reported; no experimental challenge). No polysomnography parameter independently predicted SD sensitivity. Prospective studies with controlled SD challenge are required to determine if lighter sleep is a vulnerability factor or a parallel correlate of seizure risk.