Obstructive sleep apnoea in patients with epilepsy: a meta-analysis.

Abstract

The aim of this study was to accurately determine the prevalence of obstructive sleep apnoea (OSA) in patients with epilepsy (PWE) and to evaluate the efficacy of seizure control after treating OSA. Articles were identified through a search of both MEDLINE and Embase. The articles were collected and data were extracted independently by two authors. OSA was described using the following terms: Apnoea/hypopnoea index (AHI) and respiratory disturbance index (RDI). The variables were calculated using DerSimonian and Laird's random-effects model and odds ratio (OR). The prevalence of mild-to-severe OSA in PWE was determined to be 33.4% (95% CI 20.8-46.1%), and PWE are more susceptible to OSA as compared to healthy controls (OR 2.36; 95% CI 1.33-4.18). Males were shown to be more susceptible to OSA than females (OR 3.00; 95% CI 2.25-3.99). The results also indicated that the prevalence of OSA in patients with refractory epilepsy is not higher than the prevalence of OSA in PWE overall (17.5 vs 33.4%). The prevalence of OSA was not found to be significantly different for different seizure types or in the number of antiepileptic drugs (AEDs). Patients that had been treated with continuous positive airway pressure (CPAP) were shown to have better seizure control than those untreated (OR 5.26; 95% CI 2.04-13.5). The prevalence of OSA in PWE is higher than in the general population. Additionally, the results of our study suggest that CPAP treatment results in a reduction of seizures.