Prevalence of High-Risk Obstructive Sleep Apnea and Insomnia Ascertained by STOP and Insomnia Severity Index in Adults with Epilepsy
Abstract number :
2.217
Submission category :
6. Comorbidity (Somatic and Psychiatric)
Year :
2018
Submission ID :
502000
Source :
www.aesnet.org
Presentation date :
12/2/2018 4:04:48 PM
Published date :
Nov 5, 2018, 18:00 PM
Authors :
Thapanee Somboon, Cleveland Clinic Foundation; Harneet Walia, Cleveland Clinic Foundation; Tyler Kinzy, Cleveland Clinic Foundation; Irene Katzan, Cleveland Clinic Foundation; and Nancy Foldvary-Schaefer, Cleveland Clinic Foundation
Rationale: Obstructive sleep apnea (OSA) and Insomnia are highly prevalent, however limited data exist using sleep screening instruments in epilepsy populations. We evaluated the results of the STOP and Insomnia Severity Index (ISI) and report the prevalence of high-risk OSA (STOP=2) and significant insomnia (ISI=15) and association between OSA/Insomnia and disease specific outcomes. Methods: Retrospective data collected from first Epilepsy Center visit at Cleveland Clinic Neurological Institute between March 2015 and October 2016. Subjects completed STOP and ISI, Liverpool Seizure Severity Scale (LSSS) and seizure frequency using an electronic patient entered data system. Clinical and demographic factors were summarized as means (SD), medians [IQR], or frequencies (%). Multivariate logistic regression estimated the association between disease-specific measures and STOP and ISI scores. Results: 1669 subjects (age 41.7±16.8yr, 58% female, BMI 27.41[23.58,32.32] kg/m2) were included. 32.1% were seizure free in the prior 4 weeks and 79.3% had comorbid depression. The prevalence of OSA was 33.0% and significant insomnia 26.4%. There were significant associations between LSSS and OSA/Insomnia with odds ratio 1.009 (95% CI 1.005-1.014; p<0.001) and 1.018 (95% CI 1.013-1.023; p<0.001) respectively. Patients experiencing seizures in the prior 4 weeks had higher odds of OSA (OR 1.429, 95% CI 1.073-1.901; p=0.015) and insomnia (OR 1.970, 95% CI 1.386-2.800; p<0.001). Increasing seizure frequency was not associated with increase odds of OSA or Insomnia. Conclusions: OSA and Insomnia are highly prevalent in adults with epilepsy. More abnormal STOP and ISI scores were associated with worse disease-specific outcomes. Routine screening of common, treatable sleep disorders in epilepsy populations is recommended given available treatments that improve quality of life and may reduce seizures. Funding: Cleveland Clinic Knowledge Program Data Registry and Neurological Institute Center for Outcomes Research and Evaluation