The effect of air travel on sleep and seizure frequency for individuals with epilepsy

Abstract

This study is an empirical investigation of a clinical observation that air travel, particularly extended east-west flight, promotes an increase in seizures for individuals with epilepsy. Literature on sleep, sleep loss, circadian rhythm disruption and transmeridian desynchronosis is reviewed to consider how these flight-related factors may lower seizure threshold. It was hypothesized that seizures would be more prevalent after air travel and that circadian rhythm disruption, sleep loss, sleep variability, and baseline seizure frequency would be related to an increase in post-flight seizure frequency. Thirty-seven individuals with epilepsy self-monitored their sleep and seizure frequency for one week prior to and one week after flying. Most individuals did not experience seizures during their involvement with the study. Of the 14 subjects that reported seizures, nine experienced an increase in seizure frequency, two experienced no change, and three experienced a decrease in post-flight seizures. Seizures were significantly more frequent during the post-flight week. Subjects reported sleeping less on the night before flying and during the night of air travel. However, sleep measures were not significantly associated with an increase in seizures after flying. Subjects who experienced an increase in seizures after flying flew farther than those who did not have an increase in seizures. Subjects with higher rates of baseline seizures were most likely to experience an increase in seizures after flying. This study suggests that air travel can promote seizures, particularly when the flight is extended and when the individual with epilepsy has poor control over his or her seizures. The theoretical and clinical implications of these results are discussed.