Authors :
Presenting Author: Marion Lazaj, MSc – Queen's University
Garima Shukla, MBBS, MD, DM, FRCPC – Queen's University; Lysa Boissé Lomax, MD MSc FRCPC CSCN – Queen's University; Gavin Winston, MD – Queen's University; Ana Johnson, PhD – Queen's University; Tristan Derry, BScH – Queen's University
Rationale:
Pooled mortality has been observed to be almost threefold among people with epilepsy (PWE). ‘Epilepsy related deaths’ (including sudden unexpected death in epilepsy [SUDEP], status epilepticus, drowning and others), are more common than other causes among PWE. Nearly 80% of SUDEP events occur during sleep. Abnormalities in sleep quality and architecture are encountered frequently among persons with epilepsy, especially those with ‘difficult to control epilepsy’. Primary sleep disorders like sleep disordered breathing and insomnia disorder are widely prevalent in the general population and more so in PWE. Currently, SUDEP risk evaluation and biomarkers constitute a highly investigated research area. Few studies have explored the link of sleep with SUDEP and all-cause mortality risk in epilepsy. The primary objective of this study was to evaluate the relationship between mortality risk in epilepsy with diagnosis of primary sleep disorder(s).
Methods:
Consecutive patients diagnosed with active epilepsy at our tertiary care Canadian epilepsy clinic during a four year study period (2018 to 2022) formed the study population. Those with severe and/or acute co-morbidities and those with incomplete data were excluded. The study database captured information on demographics, clinical and neurophysiological epilepsy and sleep details as well as accidents and hospitalization records. Mortality risk evaluation was conducted using the modified SUDEP-7 scale , with ‘high mortality risk’ implied by scores. Diagnosis of primary sleep disorders had been made by a qualified sleep physician (based on ICSD-3 criteria). PWE included in this study were stratified into two groups: PWE without a diagnosis of a comorbid sleep disorder=Group 1 and PWE with a diagnosis of a sleep disorder=Group 2. Chi-square and two-sample t-test analyses, with a cut off p< 0.05 value, were conducted to evaluate differences between the two groups in terms of mortality risk-related variables.