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Synergistic effect of sleep depth and seizures correlates with postictal heart rate
Author(s) -
Schomer Andrew C.,
Lynch Morgan,
Lowenhaupt Stephanie,
Leonardo Juliana,
Baljak Valentina,
Clark Matthew,
Kapur Jaideep,
Quigg Mark
Publication year - 2021
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16869
Subject(s) - heart rate , epilepsy , anesthesia , heart rate variability , rapid eye movement sleep , medicine , sleep (system call) , cardiology , electroencephalography , psychology , blood pressure , psychiatry , computer science , operating system
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.