Sleep apnea increases sudden cardiac arrest risk in children with epilepsy

For pediatric patients with epilepsy, sleep apnea (SA) is associated with an increased risk for sudden cardiac arrest (SCA) and cardiac dysrhythmia, according to a study published online Aug. 19 in Pediatrics.

Po-Ming Wu, M.D., from National Cheng Kung University in Taiwan, and colleagues examined the incidence and risk for SCA and cardiac dysrhythmia in pediatric patients with epilepsy and SA. Propensity scores were used to match two cohorts: patients with epilepsy with and without SA. During five- and 10-year follow-up periods, SCA and cardiac dysrhythmia were assessed.

The researchers found that compared with patients with epilepsy alone or SA alone, patients with both epilepsy and SA had the highest incidence of SCA (50.5 versus 20.0 and 9.0 per 10,000 person-years, respectively). During five- and 10-year follow-up periods, patients with epilepsy and SA had an increased risk for SCA (hazard ratios [HRs], 1.99 and 1.74, respectively); an increased risk for cardiac dysrhythmia was seen over 10 years (HR, 2.06). The risk for SCA was increased in association with refractory epilepsy (odds ratio [OR], 1.74). An increased SCA risk was seen in association with long-term continuous positive airway pressure therapy (OR, 3.41), while a reduced risk was seen with adenotonsillectomy (OR, 0.40).

“These findings highlight the importance of individualized treatment strategies in pediatric patients with epilepsy and comorbid SA to reduce the risk of SCA,” the authors write.

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