Sleep in Lennox-Gastaut Syndrome: A Scoping Review

Area of Science:

• Neurology
• Sleep Medicine
• Epileptology

Background:

• Lennox-Gastaut syndrome (LGS) is a severe epileptic encephalopathy with significant cognitive impairment.
• Sleep disturbances are highly prevalent in LGS, negatively impacting quality of life.
• Existing research lacks a comprehensive analysis of sleep architecture, microstructure, breathing, and circadian regulation in LGS.

Purpose of the Study:

• To conduct a scoping review of current evidence on sleep abnormalities in Lennox-Gastaut syndrome.
• To identify critical knowledge gaps regarding sleep in LGS.
• To establish priorities for future research into LGS sleep disturbances.

Main Methods:

• Conducted a scoping review following PRISMA-ScR guidelines, searching PubMed, Embase, Ovid, and ClinicalTrials.gov.
• Included observational and interventional studies using polysomnography, video-EEG, actigraphy, or sleep questionnaires from inception to October 2025.
• Synthesized data narratively due to heterogeneity and assessed methodological quality using Joanna Briggs Institute (JBI) checklists.

Main Results:

• Eleven studies (1986-2025) involving 5-16 LGS participants each were included, primarily small observational studies.
• Individuals with LGS showed disrupted sleep architecture (reduced REM sleep, fragmented NREM, attenuated spindles) and elevated cyclic alternating pattern (CAP) rates.
• Sleep-disordered breathing (SDB) and circadian rhythm dysregulation were common, with potential links to seizures and altered melatonin/cortisol profiles.

Conclusions:

• Sleep is profoundly disrupted in LGS at macrostructural and microstructural levels.
• These sleep abnormalities may worsen seizure burden, cognitive deficits, and SUDEP risk.
• Larger prospective studies integrating polysomnography, wearables, and interventions are needed to explore therapeutic potential.