使用 rSUDEP-7 预测阻塞性睡眠呼吸暂停与癫痫意外猝死（SUDEP）的风险相关。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2024-11-01 DOI:10.1016/j.yebeh.2024.110121

Atiwat Soontornpun , Christian Mouchati , Noah D. Andrews , James Bena , Madeleine M. Grigg-Damberger , Nancy Foldvary-Schaefer

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引用次数: 0

摘要

背景和目的：使用修订版 SUDEP 风险量表（rSUDEP-7）评估 PSG 证实的 OSA 与 SUDEP 风险之间的关系：使用修订版 SUDEP 风险量表（rSUDEP-7）评估 PSG 证实的 OSA 与 SUDEP 风险之间的关系：确定了 2004-2016 年在克利夫兰诊所接受 PSG 检查的成人癫痫患者 (AWE)。睡眠呼吸暂停-低通气指数（AHI）≥-5/小时定义为 OSA；AHI≥15 为中度/重度 OSA。SUDEP 风险采用 rSUDEP-7 进行评估：rSUDEP-7 分数越高，SUDEP 风险越大。rSUDEP-7 评分与 OSA 组别（AHI≥15 vs. OSA）之间的关系：在 214 名 AWE 中，134 人（62.6%）存在 OSA；75 人（35%）为中度/重度 OSA。AHI≥15的AWE更可能是男性和老年人，体重指数（BMI）更高，强直阵挛发作（TCS）频率更高，癫痫持续时间更长，更可能患有耐药性癫痫（DRE）和与睡眠相关的癫痫发作（所有p2 nadir与rSUDEP-7呈负相关（p=0.007））。经调整后，AHI≥15 的 AWE 平均 rSUDEP-7 得分为 1.14 分（95% CI 0.55-1.72，p 讨论：经 PSG 确认患有中度/重度 OSA 的亚博app客服生，尤其是年龄较大且患有 GTC 的亚博app客服生，其 rSUDEP-7 评分较高，可能会增加他们发生 SUDEP 的风险。我们的研究结果支持对亚博app客服生进行 OSA 常规筛查。还需要进一步研究证实 OSA 对 SUDEP 风险的意义和影响。

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Obstructive sleep apnea is associated with risk for sudden unexpected death in epilepsy (SUDEP) using rSUDEP-7

Background and Objective

Evaluate relationships between PSG-confirmed OSA and SUDEP risk using the revised SUDEP Risk Inventory (rSUDEP-7).

Methods

Identified adults with epilepsy (AWE) who underwent PSG 2004–2016 at Cleveland Clinic. OSA was defined as apnea-hypopnea index (AHI)- ≥-5/h sleep; moderate/severe OSA as AHI≥15. SUDEP risk was assessed using rSUDEP-7: higher rSUDEP-7 score, greater SUDEP risk. Associations between rSUDEP-7 score and OSA groups (AHI≥15 vs. <15) were evaluated using Wilcoxon rank-sum tests and multivariable linear models adjusting for age, sex, BMI, and smoking status. Spearman correlations measured relationships between rSUDEP-7 score with AHI and oxygen desaturation indices (ODI).

Results

OSA was present in 134 (62.6 %) of 214 AWE; moderate/severe in 75 (35 %). AWE with AHI≥15 were more likely to be male and older, had higher BMI, greater frequency of tonic-clonic seizures (TCS), longer epilepsy duration, and more likely to have drug-resistant epilepsy (DRE) and sleep-related seizures (all p< 0.05). The median rSUDEP-7 score was 1 (0,3) but 37.4 % had a score ≥3 (high SUDEP risk), and 11.7 % ≥5 (highest SUDEP risk). rSUDEP-7 scores were higher in those with AHI≥15 (3 vs. 1, p = 0.001). Higher AHI and ODI 3% positively correlated with rSUDEP-7 (p=0.002 and p=0.016) while SpO₂ nadir negatively correlated with rSUDEP-7 (p=0.007). After adjustments, AWE with AHI≥15 had mean rSUDEP-7 score 1.14 points (95% CI 0.55–1.72, p<0.001) higher than those with AHI<15.

Discussion

AWE with PSG-confirmed moderate/severe OSA especially those who are older and have GTC had higher rSUDEP-7 scores potentially increasing their risk for SUDEP. Our findings support routine screening for OSA in AWE. Further studies confirming the significance and impact of OSA on SUDEP risk are needed.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.