New research is exploring whether disrupted sleep followed by a head injury increases the risk of epilepsy, particularly in people with high-risk occupations.
Epilepsy, a neurological condition causing seizures, affects millions globally. Research led by assistant professor Oleksii Shandra is investigating how a combination of chronic sleep disruption and traumatic brain injury may increase the likelihood of developing the condition.
The study—funded by a US$758,808 grant from the US Department of Defense’s Army Medical Research and Development Command—has implications for people in hazardous jobs such as firefighters, athletes, truck drivers, soldiers and veterans.
Members of the military are particularly affected by sleep loss due to intensive training and deployments. They also face a heightened risk of head injuries, with tiredness and reduced alertness further increasing danger, Shandra said.
Shandra said: “The question is, when a person is experiencing chronic sleep disruption and then undergoes a traumatic brain injury, how much does their risk of developing epilepsy increase?
“This is a very important yet understudied question in our field.
“If we can identify the people who have a very high chance of developing epilepsy, we might be able to help them before the seizures arrive.”
Epilepsy has a range of known causes—from genetics and metabolic issues to infection—but Shandra is focusing on the link between poor sleep and brain injury because both are so prevalent.
According to the US Department of Defense, more than 50 per cent of armed services personnel had six or fewer hours of sleep a night between 2005 and 2018.
During the same period, approximately 500,000 service members sustained a traumatic brain injury, according to the Traumatic Brain Injury Center of Excellence.
The current project builds on Shandra’s earlier research at Virginia Tech, where he worked as a senior research scientist on a US$2.6m epilepsy study.
That work analysed over 24,000 hours of EEG data and identified electrographic biomarkers—specific brain wave patterns in mice with head injuries—that could predict later epilepsy onset.
Shandra said: “This served as a springboard into my current research.
“Now that we know what patterns to look for after a traumatic brain injury, we can build on that research by studying the effects of chronic sleep disruption, too.”
He is examining how brain activity is regulated by excitatory and inhibitory signals.
The brain’s excitatory system (glutamate) acts like an accelerator, while the inhibitory system (GABA) works as a brake. If this balance is disrupted, seizures may occur.
He said: “A balance between the systems is crucial. Yet, this equilibrium is disrupted by traumatic brain injuries. I fear that sleep disruption prior to the injury will only exacerbate this imbalance.”
If the hypothesis holds true, it could lead to targeted prevention.
The team will explore whether transcranial magnetic stimulation (TMS)—a non-invasive technique using magnetic pulses to activate brain cells—could help.
Already approved in the US for treating depression, the method may also help restore the brain’s inhibitory control.
