Sleep apnea, hypoxia, and late-onset epilepsy: the Atherosclerosis Risk in Communities study.

IF 5.3 2区医学 Q1 CLINICAL NEUROLOGY Sleep Pub Date : 2024-06-13 DOI:10.1093/sleep/zsad233

Christopher M Carosella, Rebecca F Gottesman, Anna Kucharska-Newton, Pamela L Lutsey, Adam P Spira, Naresh M Punjabi, Andrea L C Schneider, Kelsie M Full, Emily L Johnson

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Abstract

Study objective: Sleep apnea is associated with unexplained epilepsy in older adults in small studies. We sought to determine the relationship between sleep apnea and additional sleep characteristics and late-onset epilepsy (LOE), adjusting for comorbidities, using data from the large, prospective Atherosclerosis Risk in Communities (ARIC) Study cohort.

Methods: We used Medicare claims to identify cases of LOE in ARIC participants. We used polysomnography data from 1309 ARIC participants who also participated in the Sleep Heart Health Study in 1995-1998, and demographic and comorbidity data from ARIC. Later risk of LOE was evaluated using survival analysis with a competing risk of death. We also used survival analysis in 2672 ARIC participants to identify the association between self-reported obstructive sleep apnea (2011-2013), and the risk of subsequent LOE.

Results: Late-midlife oxygen desaturation to less than 80% during sleep was associated with subsequent development of LOE, adjusted subhazard ratio 3.28 (1.18-9.08), but the apnea-hypopnea index was not related. Participant report of diagnosis of sleep apnea in 2011-2013 was also associated with subsequent LOE, adjusted subhazard ratio 2.59 (1.24-5.39).

Conclusions: Sleep apnea and oxygen saturation nadir during sleep are associated with LOE, independently of hypertension and other comorbidities. These potentially modifiable risk factors could have large clinical implications for LOE.

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睡眠呼吸暂停、缺氧和迟发性癫痫：社区动脉粥样硬化风险研究。

研究目的：在小型研究中，睡眠呼吸暂停与老年人不明原因癫痫有关。我们试图利用来自大型前瞻性社区动脉粥样硬化风险（ARIC）研究队列的数据，确定睡眠呼吸暂停与额外睡眠特征和晚发性癫痫之间的关系，并对合并症进行调整。方法：我们使用医疗保险索赔来确定ARIC参与者的迟发性癫痫（LOE）病例。我们使用了1309名参与1995-1998年睡眠心脏健康研究的ARIC参与者的多导睡眠图数据，以及ARIC的人口统计学和共病数据。LOE的后期风险使用生存分析和竞争性死亡风险进行评估。我们还对2672名ARIC参与者进行了生存分析，以确定自我报告的阻塞性睡眠呼吸暂停（2011-2013）与随后LOE风险之间的关系。结果：中年晚期睡眠时氧饱和度降低至80%以下与随后LOE的发展有关，调整后的亚氮杂比为3.28（1.18-9.08），但呼吸暂停低通气指数无关。2011-2013年诊断为睡眠呼吸暂停的参与者报告也与随后的LOE相关，调整后的亚氮杂比为2.59（1.24-5.39）。结论：睡眠呼吸暂停和睡眠中的氧饱和度最低点与LOE有关，与高血压和其他合并症无关。这些潜在的可改变的风险因素可能对LOE有很大的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep 医学-临床神经学

CiteScore

10.10

自引率

10.70%

发文量

1134

审稿时长

3 months

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