Abstract
BackgroundA high prevalence of obstructive sleep apnea (OSA) has been reported in medically refractory epilepsy patients, and there is increasing evidence that treatment of OSA in refractory epilepsy patients would reduce seizure frequency.ObjectiveStudying the frequency of occurrence of OSA in a group of refractory epilepsy patients, compared to a matched group with medically controlled epilepsy.MethodsSixty patients with epilepsy, 30 patients with controlled epilepsy (group I), and 30 patients with refractory epilepsy (group II) were included. All patients underwent overnight polysomnogram and sleep EEG and completed Sleep Apnea Sleep Disorders Questionnaire (SASDQ). All patients had normal general and neurological examination.ResultsThe frequency of OSA was found to be 10% in patients with controlled epilepsy, while its frequency in patients with refractory epilepsy was found to be 16.7%, yet this was statistically insignificant. In addition, O2 desaturation nadir was higher in group II, compared to group I with no statistical significance. In the controlled epilepsy group, we found that older patients tend to have higher Apnea–Hypopnea Index (AHI). Moreover, it was found that older subjects, with early onset of epilepsy, and longer duration of the illness tend to have higher AHI in group II.ConclusionThere is an association between refractory epilepsy and OSA, especially regarding O2 desaturation during sleep. In addition, older age, early onset of epilepsy, and longer duration of illness are independent risk factors for the OSA in patients with refractory epilepsy.
Highlights
It is noted that obstructive sleep apnea (OSA) coexists with epilepsy [1]
There is an association between refractory epilepsy and OSA, especially regarding O2 desaturation during sleep
We found that three out of five refractory epilepsy patients with OSA (60%) and two out of three patients in the controlled epilepsy group with OSA (66.7%) had mild OSA
Summary
It is noted that obstructive sleep apnea (OSA) coexists with epilepsy (in 10% of adult epilepsy patients, 20% of children with epilepsy, and up to 30% of drug-resistant epilepsy patients) [1]. The potential mechanisms underlying the probable association between OSA and increased seizure frequency could be related to changes in sleep architecture, intermittent hypoxia, or sleep deprivation [2]. It is not surprising that treatment of OSA may decrease seizure frequency [3]. We aim at studying the frequency of occurrence of OSA in a group of refractory epilepsy. A high prevalence of obstructive sleep apnea (OSA) has been reported in medically refractory epilepsy patients, and there is increasing evidence that treatment of OSA in refractory epilepsy patients would reduce seizure frequency
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