TOPLINE:

Comorbid primary sleep disorders were associated with higher risks for sudden unexpected death in epilepsy (SUDEP), all-cause mortality, and accidents in patients with epilepsy than those without a sleep disorder, a retrospective study found.

METHODOLOGY:

• Researchers conducted a retrospective chart review of 1506 patients with active epilepsy seen at a Canadian tertiary care epilepsy clinic from 2018 to 2022.
• Patients were categorized as having comorbid primary sleep disorders (the SleepDis group; n = 376; median age, 36 years) or no sleep disorder (control group; n = 1130; median age, 35 years).
• Sleep disorders included obstructive sleep apnea, insomnia disorder, restless legs syndrome, narcolepsy, and other primary sleep disorders.
• SUDEP risk was evaluated using the revised SUDEP-7 Inventory (rSUDEP-7), with scores ≥ 5 categorized as high risk and scores < 5 categorized as low risk.
• Outcomes included SUDEP risk scores, all-cause mortality, accidents, and hospitalizations. Data on sociodemographic and clinical characteristics were additionally obtained.

TAKEAWAY:

• The SleepDis group had significantly higher ordinal rSUDEP-7 scores than the control group (median, 3 vs 2; P = .0007).
• After adjusting for age, sex, living situation, and epilepsy type and duration in the multivariable model, the SleepDis group had increased odds of higher rSUDEP-7 scores (≥ 5) than the control group (odds ratio [OR], 1.93; 95% CI, 1.02-3.64). The ordinal model showed similar results (OR, 1.46; 95% CI, 1.17-1.81).
• All-cause mortality (3% vs 1%; P = .0307) and accidents (26% vs 21%; P = .0472) were higher in the SleepDis group than the control group, with no significant difference in hospitalizations.
• Subjective sleep disturbances were more common in the SleepDis group, including nocturnal awakenings (37% vs 20%) and excessive daytime sleepiness (50% vs 40%).
• Between-group differences in high vs low SUDEP risk were not statistically significant.

IN PRACTICE:

“Incorporating clinical sleep evaluation may improve SUDEP risk assessment and broaden mortality risk stratification in epilepsy,” the investigators of the study wrote.

SOURCE:

The study was led by Marion Lazaj, Queen’s University, Kingston, Ontario, Canada. It was published online on June 1 in Epilepsia.

LIMITATIONS:

The study had a retrospective design, and polysomnography data were available for a relatively small percentage of patients.

DISCLOSURES:

No funding information was provided for the study. Disclosure information for the study investigators is available in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.