Men with nonapnea sleep disorders have a high risk of developing subsequent epilepsy: A nationwide population-based cohort study

Abstract

ObjectiveThis nationwide population-based cohort study evaluated the effects of nonapnea sleep disorders (NSDs) on the development of epilepsy. MethodsWe identified 63,865 patients aged ≥20years, diagnosed with NSDs (ICD-9-CM: 307.4 or 780.5), and without coding for apnea-related sleep disorders (ICD-9-CM: 780.51, 780.53, or 780.57) during 2000–2003 as the NSD cohort. In addition, we enrolled a comparison cohort of 127,728 patients. We calculated the adjusted hazard ratio (aHR) for developing epilepsy (ICD-9-CM: 345) after adjustment for age, sex, comorbidities, and drug use. A Kaplan–Meier analysis was used to measure the cumulative incidence of epilepsy between the 2 groups until the end of 2011. ResultsThe cumulative incidence of epilepsy was significantly higher in the NSD cohort than in the comparison cohort. The aHR for developing epilepsy in the NSD cohort was 1.52 (95% CI=1.37–1.69). The risk of developing epilepsy was higher among males (aHR=1.41) than among females. The age-stratified effects of NSDs on developing epilepsy were the highest among patients aged ≥65years. When comorbidities and NSDs coexisted, the risk of epilepsy was specifically increased in patients having an NSD and stroke (aHR: 8.61, 95% CI: 7.43–9.98) in addition to brain tumors (aHR: 7.66, 95% CI: 5.06–11.6). ConclusionThis study indicated that patients with NSDs have a higher risk of developing epilepsy and that the risk is much higher among men and older patients. These findings suggest that NSDs constitute a predisposing, possibly independent factor for developing subsequent epilepsy in adulthood.