Assignment task: 50-year-old man with a history of hypertension, tobacco use disorder, and epilepsy on phenytoin presents to the ER after an event where the patient lost consciousness and was found to be convulsing in all four extremities for a period of 45 seconds. After awakening, the patient was very sedated, which lasted for a period of one hour. Upon examination, you notice a laceration on the lateral aspect of the patient's tongue and the patient appears to have lost continence during the event. Upon further questioning, the patient states that he had recently not slept for the past two days. The patient's phenytoin level is 20 microgram/mL. Urine toxicology is positive for marijuana. Which of the following factors is the most likely precipitant of this patient's seizure? Marijuana use Medication noncompliance Sleep deprivation Tobacco use