1150 Memory and Executive Dysfunction are More Common Among Children and Adults with Epilepsy and Poor Sleep Health

Abstract Introduction People with epilepsy (PWE) are 2-3+ times more likely to have poor sleep health and often report cognitive issues, including problems with attention and memory. Given the importance of sleep for cognition and memory consolidation, we hypothesized that memory and executive dysfunction are worse for PWE with poor sleep health. Methods This cross-sectional study investigated two U.S. surveys, the 2022 National Health Interview Survey and the 2016-2023 National Survey of Children’s Health, to investigate sleep as a modifier of concentration or memory difficulty among Americans with (n=2,675 children; n=496 adults) or without (n=217,579 children; n=27,128 adults) epilepsy. Analyses evaluated self-reported measures of sleep health (bedtime regularity, difficulty falling or staying sleep, sleep duration, or use of sleep medication) and physical activity on cognitive outcomes in survey-weighted Chi-square tests and logistic regression models adjusted for age, sex, education, race and ethnicity, health insurance coverage, and family income ratio. Results In the general sample, presence of sleep problems was associated with memory and executive dysfunction (children ORadj=1.5-2.0; adult ORadj=1.8-2.5; p 0.05), while physical activity was protective (children and adult ORadj=0.5-0.7; p 0.05). When analyzed by epilepsy status, children with epilepsy (CWE) had 7 times higher odds of memory, concentration, or decision-making difficulty compared to children without epilepsy (ORadj=7.3; 95%CI: 6.21, 8.56; p 0.001), and AWE had 3.5 times higher odds of memory or concentration difficulty compared to people without epilepsy (ORadj=3.7; 95%CI: 2.6, 4.2; p 0.001). Among CWE and AWE, worse sleep health, but not physical activity, was associated with greater cognitive difficulty (p 0.05). Conclusion In this large, nationally-representative study, memory and executive dysfunction were worse among PWE with poor sleep health. Memory is often a top concern among PWE, but can be underappreciated by clinicians. Sleep and memory problems may be important factors in epilepsy-related disparities, such as in social or developmental outcomes and educational attainment. Healthcare providers should consider screening for sleep health among PWE, particularly for patients with cognitive complaints. Future work should longitudinally track sleep and memory and seek to develop treatment approaches that improve memory function and sleep in PWE. Support (if any) HERCULES pilot award NIEHS P30ES019776 and NINDS R01 NS088748