Epilepsy, sleep and sudden unexpected death

BackgroundSudden unexpected death is arare but severe complication in patients with epilepsy. The risk for sudden unexpected death in epilepsy (SUDEP) is increased at night and in people with nocturnal seizures, justifying acloser look into the relationship between sleep and SUDEP.ObjectiveThis article presents the current knowledge on the underlying pathophysiology and specific potential hazards for SUDEP, with aparticular focus on sleep-related aspects. Furthermore, possible countermeasures and strategies for the prevention of SUDEP are described.Material and methodsRelevant current scientific reports and studies related to the topic of SUDEP and sleep are analyzed and are presented in this narrative review.ResultsThe occurrence of SUDEP is predominantly in young male adults. Most documented cases of SUDEP begin with a nocturnal epileptic seizure followed by aneurovegetative breakdown encompassing respiratory and cardiac decompensation, accompanied by ageneralized suppression of EEG amplitudes.ConclusionAn early restoration of ventilation and cardiovascular circulatory functions in acute cases can interrupt the potentially fatal cascade. The prevention of epileptic seizures, especially generalized tonic-clonic seizures, by means of effective pharmacotherapy, epilepsy surgery or neurostimulation is of utmost importance for prevention.