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

期刊介绍： SLEEP® publishes findings from studies conducted at any level of analysis, including: Genes Molecules Cells Physiology Neural systems and circuits Behavior and cognition Self-report SLEEP® publishes articles that use a wide variety of scientific approaches and address a broad range of topics. These may include, but are not limited to: Basic and neuroscience studies of sleep and circadian mechanisms In vitro and animal models of sleep, circadian rhythms, and human disorders Pre-clinical human investigations, including the measurement and manipulation of sleep and circadian rhythms Studies in clinical or population samples. These may address factors influencing sleep and circadian rhythms (e.g., development and aging, and social and environmental influences) and relationships between sleep, circadian rhythms, health, and disease Clinical trials, epidemiology studies, implementation, and dissemination research.

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