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Abstract Details

GETTING LESS SLEEP DURING THE PANDEMIC: Subtitle : Auditing the Kings Sleep EEG Service 2019-2020

Introduction: A routine EEG in wakefulness detects epileptiform abnormalities in 40% of patients with epilepsy. The chance of finding epileptiform discharges increases to 80%-90% with EEG recordings during sleep. King's College Hospital in London is one of the few centres in the United Kingdom performing medication induced sleep EEG with approximately 1600-1800 sleep EEG attendees annually. Prior to the Covid-19 pandemic, we typically administered Seconal (Quinalbarbitone) to adult patients undergoing sleep EEG necessitating a recovery period afterwards. To avoid departmental overcrowding and help adherence to social distancing, we replaced Seconal with Melatonin, which we previously used only in our paediatric population.

Aim and objective: To assess efficacy of Melatonin-induced sleep in adults by comparing a 2019 cohort (who received Seconal) with the 2020 cohort (who received Melatonin).

Method: We retrospectively reviewed the reports of all adult sleep EEG patients (over 16 years) for the same three month period (May-July) in 2019 and 2020. Successful sleep was defined as reaching sleep stage N2.

Results: In the 2019 study period, 246 patients attended for sleep EEG. 161/181 who received Seconal reached stage II sleep (89%). In the 2020 cohort, among 159 sleep attendees, 75/135 patients who received Melatonin reached stage II sleep (53%). The difference in proportion of patients attaining sleep is statistically significant (2=45.6; p<0.001).

Conclusion: The audit demonstrates that 36% fewer adults reached stage 2 sleep when melatonin was administered. This is a fourfold increase of our failure rate to induce sleep (11% in 2019 vs 47% in 2020). This has resource implications, as many patients will need a repeat test. We will discuss possible approaches to improve the yield in the current situation. It is also noted that there were fewer contraindications to Melatonin (135/159 [85%] were given the drug vs 181/246 [73%] for Seconal).

TitleForenamesSurnameInstitutionLead AuthorPresenter
DrMay Chaw Thazin Win Kings college hospital,London
DrJoelWinstonKing’s College London/King’s College Hospital
DrFranzBrunnhuberDepartment of Clinical Neurophysiology
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