SUDEP Action welcomes new research highlighting the risk of SUDEP in prone position

A new systematic review led by JA Liebenthal, published in Neurology on 21 January 2015 has been released looking at previous SUDEP research data to explore the link between the prone position and SUDEP. The prone position is defined as lying on the belly, chest, or face, with or without obstruction of the nose or mouth (Kloster R, Engelskjon T. Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and a search for risk factors. Journal of Neurology, Neurosurgery & Psychiatry 1999; 67:439–444).  

The study examined data across 25 studies involving 253 SUDEP cases and found the prone position was recorded in 73.3% of SUDEP deaths, whereas non-prone positions were found in 26.7% of the cases. The authors concluded that sleeping in the prone position, or remaining in a prone position post seizure is therefore a major risk factor for SUDEP, particularly in patients aged 40 years and younger who were  found to be at an increased level of risk. The study also suggested that the use of seizure detection and monitoring devices may prove to be useful. 

This research reinforces the current NICE Guidelines which state patients with epilepsy, particularly those with nocturnal seizures, should be given tailored information about the small but definite risk of SUDEP and their specific levels and areas of risk when discussing the importance of seizure management and prevention. Further information see the NICE Guidelines  

SUDEP Action has been campaigning for 20 years to raise awareness of how people need to be aware of and consider the risks associated with epilepsy. The charity welcomes this new research which highlights an important area of risk that has often been overlooked.  It also supports the researchers’ recommendations that further research is needed into the link between the prone position and SUDEP mechanisms, as well as into monitoring devices.  SUDEP Action is currently working with researchers on a Wearable Apnoea Detection Device.  

Whilst larger studies are needed, in the mean-time we would recommend that people with epilepsy who experience seizures during sleep speak with their doctor about measures they can take aimed at reducing risk. These might include avoiding the prone sleep position as another potential risk reducing measure and the use of alarms. 

In the meantime anyone can access information about the research via http://www.medscape.com/viewarticle/838415 (you will need to register to see the summary article). Or to see the full research report (you may need to register to view this): visit http://www.neurology.org/content/early/2015/01/21/WNL.0000000000001260.f...

SUDEP action will also be continuing to raise awareness using this information. Keep track of developments and support our campaigns on www.sudep.org & via our social media sites.