Abstracts

Rationale: Sudden unexpected death in epilepsy (SUDEP) could preferentially occur in Sleep. However, the incidence of SUDEP occurred in sleep ranges widely from 25 to 95% among the published case studies. Our goal of this systemic review and meta-analysis is to determine a more accurate incidence of SUDEP that occurs in sleep, which may demonstrate the significance of sleep as a risk factor for SUDEP.Methods: We conducted a systematic review and meta-analysis based on a literature search from databases PubMed and Scopus, using keywords “SUDEP” or “sudden unexpected death in epilepsy” or “sudden unexplained death in epilepsy.” Sixty seven publications met all inclusion and exclusion criteria and were included in this study.Results: Of the 916 cases of SUDEP in the 67publications, 626 (68.3%) cases of SUDEP were found to have occurred in sleep (defined as those found in sleep, in bed or in the bedroom), whereas 290 (31.7%) cases of SUDEP that occurred in wakefulness. In a subset of SUDEP patients died in sleep with body position defined, there were 81 cases occurring in prone position, while 7 cases occurred in supine position and 5 in other positions.Conclusions: Our study demonstrates a robust association of sleep with SUDEP, which suggests that sleep might be a significant risk factor for SUDEP. Meanwhile, a significant number of these cases of SUDEP occurring in sleep also showed a strong association with prone position, which may have contributed the SUDEP risk associated with sleep.