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, Christopher M Carosella Department of Neurology, Johns Hopkins School of Medicine , Baltimore, MD , USA Corresponding author. Christopher M. Carosella, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA. Email: christopher.m.carosella@gmail.com. Search for other works by this author on: Oxford Academic Rebecca F Gottesman National Institutes of Health, National Institute for Neurologic Disorders and Stroke Intramural Research Program , Bethesda, MD , USA Search for other works by this author on: Oxford Academic Anna Kucharska-Newton Department of Epidemiology, University of North Carolina , Chapel Hill, NC , USA Department of Epidemiology, University of Kentucky , Lexington, KY , USA Search for other works by this author on: Oxford Academic Pamela L Lutsey Division of Epidemiology and Community Health, University of Minnesota School of Public Health , Minneapolis, MN , USA Search for other works by this author on: Oxford Academic Adam P Spira Department of Mental Health, Johns Hopkins School of Public Health , Baltimore, MD , USA Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine , Baltimore, MD , USA Johns Hopkins Center on Aging and Health , Baltimore, MD , USA Search for other works by this author on: Oxford Academic Naresh M Punjabi Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Miami , Miami, FL , USA Search for other works by this author on: Oxford Academic Andrea L C Schneider Department of Neurology, University of Pennsylvania , Philadelphia, PA , USA Department of Biostatistics, Epidemiology, and Informatics Philadelphia, University of Pennsylvania , PA , USA Search for other works by this author on: Oxford Academic Kelsie M Full Division of Epidemiology and Community Health, University of Minnesota School of Public Health , Minneapolis, MN , USA Search for other works by this author on: Oxford Academic Emily L Johnson Department of Neurology, Johns Hopkins School of Medicine , Baltimore, MD , USA Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-6152-9229 Sleep, Volume 47, Issue 6, June 2024, zsad233, https://doi.org/10.1093/sleep/zsad233
Published:
06 September 2023
Article history
Received:
07 March 2023
Revision received:
07 July 2023
Published:
06 September 2023
Corrected and typeset:
30 April 2024
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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, Sleep apnea, hypoxia, and late-onset epilepsy: the Atherosclerosis Risk in Communities study, Sleep, Volume 47, Issue 6, June 2024, zsad233, https://doi.org/10.1093/sleep/zsad233
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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.
Graphical Abstract
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epilepsy, late-onset epilepsy, sleep apnea, hypoxia
© The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Topic:
- hypertension
- epilepsy
- hypoxia
- obstructive sleep apnea
- sleep apnea syndromes
- diagnosis
- sleep
- aric trial
- self-report
Issue Section:
Neurological Disorders
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Commentary
- Hypoxia not AHI in adults with sleep apnea midlife markedly increases risk of late-onset epilepsy—Carosella CM et al Sleep apnea, hypoxia, and late-onset epilepsy: the Atherosclerosis Risk in Communities study SLEEP-2023-0175.R1
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