Sleep Deprivation Increases Mortality Risk Among Older Adults with Epilepsy

Introduction: Among U.S. adults, over 3 million report a history of epilepsy, accounting for nearly 1.2% of the population. Sleep deprivation is a well-known risk factor for increased likelihood, intensity, and length of seizures. However, the long-term impact of sleep deprivation on people with epilepsy is not well explored. The purpose of this study was to assess mortality risk among individuals with epilepsy based on sleep duration. Methods: Data from the 2008-2018 National Health Interview Survey (NHIS) were linked with mortality data from the National Death Index (NDI) for US adults aged 65 years and older. Survival curves showed the combined effect of sleep deprivation and epilepsy, using the Kaplan-Meier product-limit method to estimate the percent survival of the subject at each point in time. Results: For all-cause mortality, the unadjusted hazard ratio (HR) for sleep deprivation to no sleep deprivation among people with epilepsy (PWE) was HR = 1.92. The adjusted HR was elevated, HR = 1.94, among individuals who had epilepsy and sleep deprivation but close to 1.0 among individuals who had a history of sleep deprivation without epilepsy after adjusting for demographic and health variables. Conclusions: From a nationally representative sample, this first-of-its-kind study in the U.S. found that sleep deprivation and epilepsy combined have worse outcomes than sleep deprivation alone. Clinicians should screen and manage sleep disorders to improve their long-term prognosis of people with epilepsy.