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      Obstructive sleep apnea in a clinical series of adult epilepsy patients: frequency and features of the comorbidity.

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      Publication date:
      Journal: Epilepsia

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          Abstract

          The aim of this study was to evaluate the rate and features of obstructive sleep apnea (OSA) in adult epilepsy patients.

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          Most cited references14

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          Recognition of obstructive sleep apnea.

          S Redline, Kingman Strohl (1996)
          Article 0 comments Cited 43 times – based on 0 reviews     Review now
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            Obstructive sleep apnea is common in medically refractory epilepsy patients.

            K Maturen, Beth Malow, D. Bowes … (2000)
            Previous reports have documented the coexistence of obstructive sleep apnea (OSA) and epilepsy and the therapeutic effects of treatment on seizure frequency and daytime sleepiness. The authors' objective was to determine the prevalence of OSA and its association with survey items in a group of patients with medically refractory epilepsy undergoing polysomnography (PSG). Thirty-nine candidates for epilepsy surgery without a history of OSA underwent PSG as part of a research protocol examining the relationship of interictal epileptiform discharges to sleep state. Subjects also completed questionnaires about their sleep, including validated measures of sleep-related breathing disorders (Sleep Apnea Scale of the Sleep Disorders Questionnaire [SA/SDQ]) and subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]). One-third of subjects had OSA, defined by a respiratory disturbance index (RDI) > or = 5. Five subjects (13%) had moderate to severe OSA (RDI > 20). Subjects with OSA were more likely to be older, male, have a higher SA/SDQ score, and more likely to have seizures during sleep than those without OSA (p < 0.05). Seizure frequency per month, the number or type of antiepileptic drugs (AED) prescribed, the localization of seizures (temporal versus extratemporal), and the ESS were not statistically different between the two groups. In our sample, previously undiagnosed obstructive sleep apnea was common, especially among men, older subjects, and those with seizures during sleep. The impact of treating OSA on seizure frequency and daytime sleepiness in medically refractory epilepsy patients warrants further controlled study.
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              Postictal central apnea as a cause of SUDEP: evidence from near-SUDEP incident.

              M Sam, E So, T Lagerlund (2000)
              While undergoing video-EEG monitoring, a 20-year-old woman had a 56-second convulsive seizure, after which she developed persistent apnea. The rhythm of the electrocardiogram complexes was unimpaired for approximately 10 seconds, after which it gradually and progressively slowed until it stopped 57 seconds later. Evaluation after successful cardio-respiratory resuscitation showed no evidence of airway obstruction or pulmonary edema. The patient had a previous cardio-respiratory arrest after a complex partial seizure without secondary generalization. Although epileptic seizures are known to be potentially arrhythmogenic to the heart, our observations strongly suggest that one probable mechanism of sudden unexplained death in epilepsy is the marked central suppression of respiratory activity after seizures.
              Article 0 comments Cited 31 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                PubMed ID:: 12790898
                DOI:: 10.1046/j.1528-1157.2003.55702.x

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