Wearable EEG feasible for measuring sleep in Dravet syndrome

Key takeaways:

• Models for sleep staging with behind-the-ear EEG compared favorably with expert consensus.
• Staging for REM sleep was more difficult with the wearable EEG compared to traditional EEG.

LOS ANGELES — A wearable, behind-the-ear EEG device is feasible for assessment of sleep patterns in young people with Dravet syndrome, according to a poster presented at the American Epilepsy Society annual meeting.

“We think behind-the-ear EEG is useful in clinical trials to monitor sleep ... you can wear it for several days,” Pieter Van Mierlo, PhD, chief scientific officer at Clouds of Care, a Belgian company that seeks clinical solutions to central nervous system issues, told Healio.

Poor sleep patterns have been established as a comorbidity in young people with epilepsy, with traditional clinical sleep examinations somewhat elaborate and invasive. As such, Van Mierlo and colleagues sought to investigate the efficacy of a wearable device to track sleep progress in both healthy controls and a cohort of pediatric patients with Dravet syndrome (DS).

Their study analyzed 50 EEG recordings taken from patients with DS at Saint-Luc University Hospital in Brussels who did not display epileptic abnormalities at the time of recording with the EEG device. A montage was subsequently created from these as well as nine other recordings culled from simultaneous traditional eight-electrode scalp EEG and behind-the-ear EEG readings.

Three independent experts examined the recordings and scored five separate sleep stages (waking, N1, N2, N3 and REM sleep), whose different staging models were then trained for automated scoring.

The researchers also collected and analyzed data from overnight EEGs from 20 young people with DS taken at Antwerp University Hospital in Belgium. Their sleep performance was evaluated in comparison with scoring from one of the three independent experts.

According to results, agreement of sleep staging was accurate with the simulated behind-the-ear EEG in the 50 healthy controls when compared with consensus scoring, with the N3 stage the easiest to detect.

In the 20 patients with DS, the performance of sleep staging with the wearable device also agreed well with the measurements of the single independent investigator.

Data further show that staging REM sleep patterns were more difficult with the wearable device, as its placement on the head does not lead to reliable measurement compared to traditional EEG.

“It seems (the model) is translatable, so that the performance of the sleep models with behind-the-ear EEG opens perspective for monitoring sleep in those more difficult patient trials,” Van Mierlo told Healio.