{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:14:58Z","timestamp":1778062498417,"version":"3.51.4"},"reference-count":45,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Pediatric patients with epilepsy are at risk for sudden cardiac arrest (SCA), and sleep apnea (SA) may exacerbate this risk. This study investigates the incidence and risk of SCA and cardiac dysrhythmia in pediatric patients with epilepsy and SA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using the TriNetX global research network, we identified pediatric patients (aged younger than 18\u00a0years) who were diagnosed with epilepsy between January 2000 and March 2025. SA was identified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and polysomnography records. Two cohorts, ie, patients with epilepsy with and without SA, were matched using propensity scores. SCA and cardiac dysrhythmia were assessed over 5- and 10-year follow-up periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The incidence of SCA was highest in patients with both epilepsy and SA (50.5 per 10\u2009000 person-years) compared with those with epilepsy alone (20.0 per 10\u2009000) or SA alone (9.0 per 10\u2009000). Patients with epilepsy and SA had an increased risk of SCA (5-year hazard ratio [HR]: 1.99; 10-year HR: 1.74; both P\u2009&amp;lt;\u2009.001) and cardiac dysrhythmia (10-year HR: 2.06; P\u2009&amp;lt;\u2009.001). Refractory epilepsy increased the risk of SCA (odds ratio [OR]: 1.74; 95% CI: 1.25\u20132.42). Additionally, long-term continuous positive airway pressure (CPAP) therapy was associated with increased SCA risk (OR: 3.41; 95% CI: 2.27\u20135.11), whereas adenotonsillectomy reduced it (OR: 0.40; 95% CI: 0.27\u20130.60).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Pediatric patients with epilepsy and SA are at significantly increased risk for SCA and cardiac dysrhythmia. Adenotonsillectomy may mitigate this risk, whereas long-term CPAP use may increase it. These findings highlight the importance of individualized treatment strategies in pediatric patients with epilepsy and comorbid SA to reduce the risk of SCA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2024-069635","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:02:16Z","timestamp":1755561736000},"source":"Crossref","is-referenced-by-count":2,"title":["Risk of Sudden Cardiac Arrest in Children With Epilepsy and Sleep\u00a0Apnea"],"prefix":"10.1542","volume":"156","author":[{"given":"Po-Ming","family":"Wu","sequence":"first","affiliation":[{"name":"1Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"2Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Wu","family":"Chiang","sequence":"additional","affiliation":[{"name":"3Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"4Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Hsien","family":"Wu","sequence":"additional","affiliation":[{"name":"5Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shang-Hsun","family":"Yang","sequence":"additional","affiliation":[{"name":"3Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"6Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei-Chun","family":"Lai","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"7Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Fang","family":"Tu","sequence":"additional","affiliation":[{"name":"1Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"2Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"issue":"1","key":"2026050605372291600_r1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1164\/ajrccm.164.1.2008171","article-title":"Sleep-disordered breathing in children","volume":"164","author":"Marcus","year":"2001","journal-title":"Am J Respir Crit Care Med."},{"issue":"2","key":"2026050605372291600_r2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ccm.2010.02.005","article-title":"Polysomnography","volume":"31","author":"Jafari","year":"2010","journal-title":"Clin Chest Med."},{"issue":"4, Sleep Neurology","key":"2026050605372291600_r3","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1212\/01.CON.0000522245.13784.f6","article-title":"Sleep-disordered breathing","volume":"23","author":"Foldvary-Schaefer","year":"2017","journal-title":"Continuum (Minneap 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