Sleeping Prone Increases Risk of Death in Epilepsy

HealthDay News — Sleeping prone, or face down, may increase the risk of sudden unexpected death in epilepsy, especially in people younger than 40, according to new research published in Neurology.

James Tao, MD, PhD, an associate professor of neurology at the University of Chicago, and colleagues reviewed 25 previously published studies that detailed 253 sudden, unexplained deaths of epilepsy patients for whom information was available on body position at time of death.

The researchers found that 73% of the patients died while sleeping in a prone position. In a subgroup of 88 cases, those younger than age 40 were four times more likely to have died in a prone sleeping position than the older people. In all, 86% of those younger than 40 and 60% of those over 40 were prone when found dead.

Based on the findings, people with epilepsy should not sleep in a prone position, Tao told HealthDay. People with epilepsy should try to sleep on their side or back and ask their bed partner to remind them. Using wrist watches and bed alarms designed to detect seizures during sleep may also help prevent sudden death, he said.

The findings draw similarities to sudden infant death syndrome (SIDS), and align with current recommendations that infants be placed on their back to sleep, and not on their stomach. Despite the similarities, the research still does not clarify the mechanism of death. 

Researchers speculated that an additional parallel may exist between SUDEP and SIDS via serotonergic pathways, which regulate both respiration and arousal in response to a fluctuation in blood CO2 levels. 


  1. Liebenthal J et al. Neurology. 2015; doi:10.1212/WNL.0000000000001260.