The diagnostic value of sleep-deprived EEG in epilepsy: A meta-analysis

Sleep deprivation has been studied as a method to induce sleep before EEG testing to improve the diagnosis of epilepsy. However, the effectiveness of sleep deprivation in diagnosing epilepsy through EEG in humans showed conflicting findings in previous studies. This meta-analysis aimed to provide statistical evidence for the diagnostic value of sleep-deprived EEG in epilepsy. A systematic search of the Web of Science and PubMed databases identified 12 relevant studies from May 1997 to the present. These studies were included to examine the diagnostic value of sleep-deprived EEG in epilepsy and its associated clinical variables, such as patient age, duration of sleep deprivation, and EEG recording duration. The results of the random effects model did not show a significant overall diagnostic effect for sleep-deprived EEG in epilepsy, but revealed high heterogeneity among the studies. Notably, this heterogeneity was not accounted for by the clinical variables analyzed. Upon excluding outliers, a trend suggesting a modest diagnostic value of sleep-deprived EEG emerged. The high heterogeneity among studies indicates the need for a standardized protocol for sleep deprivation in future studies. Overall, while sleep deprivation may have a small positive effect on EEG-based epilepsy diagnosis, further research is needed to better understand its impact and optimize its use in clinical practice.