Impaired Sleep Homeostasis and Respiratory Instability: Identifying Novel Biomarkers for Sudden Unexpected Death in Epilepsy

Highlights

• People who later died of SUDEP exhibit a pathological lack of overnight decline in slow-wave activity (SWA), suggesting impaired sleep homeostasis.
• Increased variability in inter-breath intervals during non-rapid eye movement (NREM) sleep serves as a potent differentiator for SUDEP risk.
• The coefficient of variation of the inter-breath interval demonstrated high discriminative performance (AUC 0.80) in predicting SUDEP.
• Gender-specific differences were observed, with males showing a more pronounced increase in SWA slope compared to females.

The Silent Threat: Understanding SUDEP and the Need for Biomarkers