MedPath

Sleep-Sensitive Seizure Risk Assessment With Wearable EEGs

Not Applicable
Not yet recruiting
Conditions
Epilepsy Intractable
Interventions
Device: Dreem headband
Registration Number
NCT06545643
Lead Sponsor
Duke University
Brief Summary

Epilepsy, a prevalent neurological disorder, affects 40% of patients with uncontrolled seizures despite medications. Sleep disturbance exacerbates epilepsy, and vice versa, but existing literature suffers from limitations. Studies conducted in hospital settings provide only brief observation periods and fail to capture the natural sleep environment. Wearable technology offers a promising solution, providing a nuanced understanding of the relationship between seizures and sleep. The Dreem headband, an EEG-based wearable, is well-suited for such studies, offering ease of use and validated accuracy. This technology enables extended observation periods under stable medication conditions, essential for assessing the complex interplay between sleep and epilepsy. By elucidating the impact of sleep on seizures, the researchers seek to identify patient populations where sleep significantly influences seizure susceptibility, ultimately informing personalized epilepsy treatments.

Detailed Description

The first aim of this study is to investigate how variations in sleep timing, duration, and structure influence seizure risk, particularly in individuals with sleep-sensitive seizures. The investigators will conduct longitudinal EEG assessments to analyze how changes in sleep features correlate with interictal epileptiform discharge rates and seizure occurrences over time.

The second aim is to develop a sleep quality index that predicts individual risk for sleep-sensitive seizures, the Sleep-Sensitive Epilepsy Risk Index (SERI). This index aims to predict an individual's seizure risk associated with disrupted sleep, facilitating personalized and preventative patient care.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
35
Inclusion Criteria
  • Age > 18 years
  • At least 2 seizures per week based on clinical notes
  • Patients where medications will stay stable over the study period
  • 40% of both spikes and spindles are identifiable on the dreem headband based on the screening night
Exclusion Criteria
  • Cognitive impairment
  • Psychiatric comorbidities which may influence sleep
  • No bedpartner/caregiver to observe seizures
  • Low agreement (below 60%) between Dreem's sleep scoring and manual scoring will be excluded from the study
  • Apnea-hypopnea index of > 10/h

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Dreem headbandDreem headbandParticipants will wear a Fitbit daily and a Dreem headband exclusively at night in their homes over a 21-day period as part of the data collection protocol. Additionally, they will maintain daily sleep and seizure diaries.
Primary Outcome Measures
NameTimeMethod
Spike rates per hour (epilepsy marker)21 days

Spikes will be detected by the Dreem headband

Total sleep time (sleep macrostructure)21 days

Total sleep time as measured by the Dreem headband

Seizure frequency per night (epilepsy marker)21 days

Seizures will be detected by the Dreem headband

Secondary Outcome Measures
NameTimeMethod
Sleep latency (sleep macrostructure)21 days

Sleep latency as measured by the Dreem headband

Sleep efficiency (sleep macrostructure)21 days

Sleep efficiency as measured by the Dreem headband

Sleep stage distribution (sleep macrostructure)21 days

Sleep stage distribution as measured by the Dreem headband

Sleep spindle events (sleep microstructure)21 days

Sleep spindles (10-16 Hz; duration 0.5-3 sec) as measured by the Dreem headband

Sleep slow wave events (sleep microstructure)21 days

Slow waves (0.5-4 Hz) as measured by the Dreem headband

Performance the SERI model, as measured by the area under the receiver operating characteristic curveUp to 2 years after study commencement

The Sleep-Sensitive Epilepsy Risk Index (SERI) aims to predict an individual's seizure risk associated with disrupted sleep. A high SERI will indicate a high risk for sleep-sensitive seizures, while a low value will indicate a low risk.

Wake after sleep onset (sleep macrostructure)21 days

Wake after sleep onset as measured by the Dreem headband

Specificity of the SERI modelUp to 2 years after study commencement

The Sleep-Sensitive Epilepsy Risk Index (SERI) aims to predict an individual's seizure risk associated with disrupted sleep. A high SERI will indicate a high risk for sleep-sensitive seizures, while a low value will indicate a low risk.

Performance the SERI model, as measured by F1-scoreUp to 2 years after study commencement

The Sleep-Sensitive Epilepsy Risk Index (SERI) aims to predict an individual's seizure risk associated with disrupted sleep. A high SERI will indicate a high risk for sleep-sensitive seizures, while a low value will indicate a low risk.

The F1 score ranges from 0 to 1. A value of 0 indicates poor performance, and a value of 1 represents perfect performance.

Sensitivity of the SERI modelUp to 2 years after study commencement

The Sleep-Sensitive Epilepsy Risk Index (SERI) aims to predict an individual's seizure risk associated with disrupted sleep. A high SERI will indicate a high risk for sleep-sensitive seizures, while a low value will indicate a low risk.

Trial Locations

Locations (1)

Duke University Health System

🇺🇸

Durham, North Carolina, United States

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