Original Paper
Epilepsy
and Obstructive Sleep Apnea
Peter Höllingera, Ramin Khatamib, Matthias
Guggera, Christian W. Hessa, Claudio L. Bassettib
aDepartments of Neurology and Pneumology,
University Hospital Bern, Bern, and
bDepartment of Neurology, University
Hospital Zürich, Zürich, Switzerland
Address
of Corresponding Author
European Neurology 2006;55:74-79 (DOI:
10.1159/10.1159/000092306)
 Key
Words
- Epilepsy
- Obstructive sleep apnea
- Seizure control
- Continuous positive airway pressure treatment
- Excessive daytime sleepiness
Abstract
A few publications documented the coexistence of
epilepsy and
obstructive sleep apnea (OSA). The extent, nature, and clinical
relevance of this association remain poorly understood. We
retrospectively reviewed the database of our sleep center to identify
patients with both sleep apnea and epilepsy. Characteristics of
epilepsy, sleep history, presence of excessive daytime sleepiness
[Epworth Sleepiness Scale (ESS)] and polysomnographic data were
assessed. The effect of continuous positive airway pressure (CPAP) on
seizure reduction was prospectively analyzed after a median interval of
26 months (range: 2-116 months) from the diagnosis of OSA. OSA was
found in 29 epilepsy patients (25 men and 4 women) with a median age of
56 years (range: 37-79). The median apnea hypopnea index was 33 (range:
10-85), the oxygen desaturation index was 12 (range 0-92), and 52% of
the patients had an ESS score >10. In 27 patients, epilepsy appeared
1 month to 44 years prior to the diagnosis of OSA. In 21 patients, the
appearance of OSA symptoms coincided with a clear increase in seizure
frequency or the first appearance of a status epilepticus. Treatment
with CPAP was continued with good compliance in 12 patients and led to
a significant reduction of both ESS scores and seizure frequency in 4
patients. Our data suggest the importance of considering diagnosis and
treatment of OSA in epilepsy patients with poor seizure control and/or
reappearance of seizures after a seizure-free interval.
Copyright © 2006 S. Karger AG, Basel
Author
Contacts
Prof. Dr. Claudio L. Bassetti
Neurologische Poliklinik, Universitätsspital
Frauenklinikstrasse 26
CH-8091 Zürich (Switzerland)
Tel. +41 44 255 5503, Fax +41 44 255 4649, E-Mail claudio.bassetti@usz.ch
Article
Information
Received: September 23, 2005
Accepted: January 4, 2006
Published online: March 24, 2006
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of
References : 22
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