Low Oxygen During Sleep and Sleep Apnea Could Be Linked to Late Onset Epilepsy

WASHINGTON — The National Institutes of Health released the results of a new study on the link between low oxygen levels while sleeping and epilepsy that first occurs after 60 years of age. The results of the study have been published in Sleep.

“There’s increasing evidence that late-onset epilepsy may be indicative of underlying vascular disease, or neurodegenerative disease, even potentially as a preclinical marker of neurodegenerative disease,” Rebecca Gottesman, M.D., Ph.D., chief of the Stroke Branch at the NIH’s National Institute of Neurological Disorders and Stroke, and an author on the study, said in a press release.

Researchers, led by Christopher Carosella, M.D., assistant professor of neurology at Johns Hopkins University, Baltimore, identified cases of late-onset epilepsy using Medicare claims and analyzed sleep data from more than 1,300 participants in a study of sleep-disordered breathing and cardiovascular disease. 

The results showed people whose oxygen saturation fell below 80% during sleep, a condition known as nocturnal hypoxia, were three times more likely to develop late-onset epilepsy compared to those who did not have similarly low oxygen levels.

The researchers went on to say “participants with self-reported sleep apnea in later life were twice as likely to develop late-onset epilepsy as those without the sleep disorder.”

The release pointed out sleep apnea is known to be a risk factor for poor brain health in other ways, including risk of stroke and dementia, but an association with epilepsy had not been described previously. 

“The link to hypoxia suggests that repeated chronic exposure to low oxygen levels overnight might lead to brain changes that ultimately lead to risk of epilepsy. The study can’t determine whether treating or preventing sleep apnea might reduce the risk of epilepsy, but it does suggest that this may be an important potential target for reducing risk of late-onset epilepsy,” the authors said.

“Discovering a reversible cause for the development of any type of idiopathic epilepsy is an aspirational goal for epilepsy researchers or clinicians,” said Carosella. “We hope this study might be a small first step in that direction and also an encouragement to evaluate and treat sleep disorders in patients with epilepsy.”

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