Abstract Details

Title Sleep Apnea is Associated with High Mortality Risk in Children with Severe Epilepsies: An Observational Analysis from Large Scale US Claims Data

Topic Sleep

Presentation(s) S6 - Sleep (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Background Sleep apnea is a common and serious sleep disorder characterized by recurrent breathing interruptions during sleep that may cause cardiovascular disease, cognitive impairment, and increased risk of all-cause sudden death. The association between sleep apnea and mortality in individuals with severe epilepsy remains poorly understood.

Objective To describe the mortality risk of sleep apnea in patients with severe epilepsy by analyzing data from a US claims database.

Design/Methods In this retrospective observational study using the Komodo US claims database, patients with severe epilepsy were included if they met ≥2 of the following criteria between January 1, 2018, to December 31, 2022: an epilepsy-related emergency department or hospital admission, status epilepticus diagnosis, or generalized tonic-clonic seizures. A total of 2,355,410 patient-years were captured from 968,993 unique patients. Patients with Central Sleep Apnea (CSA: 15,486 patient-years) and Other Sleep Apnea (OSA, including obstructive apnea: 313,024 patient-years) were identified. Additional comorbidities were defined using the Charlson Comorbidity Index. Standardized mortality ratios (SMRs) were reported by age group.

Results Children (ages 1-17) with severe epilepsy and CSA or OSA had an SMR of 135.9 and 74.2, respectively. SMRs for children with congestive heart failure, hemiplegia/paraplegia, cerebrovascular disease, and chronic pulmonary disease were 132.3, 74.9, 55.3, and 44.6, respectively, versus 27.7 for all severe epilepsy. SMRs decreased with age for all comorbidities analyzed. Forty-six percent of patients with sleep apnea (CSA & OSA) and severe epilepsy were on positive airway pressure treatments (CPAP & Bi-PAP).

Conclusions

We show that sleep apnea is associated with increased mortality in patients 1-17 years old with severe epilepsy. Further research is warranted to inform clinical practice and raise awareness of the elevated mortality risk of sleep apnea in this vulnerable age group.

Authors/Disclosures
Stefanie Dedeurwaerdere, PhD PRESENTER	Mrs. Dedeurwaerdere has received personal compensation for serving as an employee of UCB Pharma. Mrs. Dedeurwaerdere has stock in UCB Pharma. Mrs. Dedeurwaerdere has received intellectual property interests from a discovery or technology relating to health care.
DANIEL S. LLOYD	Mr. LLOYD has received personal compensation for serving as an employee of UCB.
Alexis Davis, MS	Ms. Davis has nothing to disclose.
Michael McLinden	No disclosure on file
John van Zyl	Mr. van Zyl has received personal compensation for serving as an employee of UCB.
Amelie Lothe, PhD	Dr. Lothe has received personal compensation for serving as an employee of UCB. Dr. Lothe has stock in UCB.
CHRIS CLARK	Mr. CLARK has received personal compensation for serving as an employee of UCB.

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