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October 10, 2000

Obstructive sleep apnea is common in medically refractory epilepsy patients

October 10, 2000 issue
55 (7) 1002-1007


Background: 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).
Methods: 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]).
Results: One-third of subjects had OSA, defined by a respiratory disturbance index (RDI) ≥ 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.
Conclusions: 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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Information & Authors


Published In

Volume 55Number 7October 10, 2000
Pages: 1002-1007
PubMed: 11061259

Publication History

Received: March 27, 2000
Accepted: June 12, 2000
Published online: October 10, 2000
Published in print: October 10, 2000


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Affiliations & Disclosures

Beth A. Malow, MD, MS
From the Michael S. Aldrich Sleep Disorders Laboratory, Department of Neurology, University of Michigan Medical School, Ann Arbor.
Kirk Levy, MD
From the Michael S. Aldrich Sleep Disorders Laboratory, Department of Neurology, University of Michigan Medical School, Ann Arbor.
Katherine Maturen, BA
From the Michael S. Aldrich Sleep Disorders Laboratory, Department of Neurology, University of Michigan Medical School, Ann Arbor.
Robert Bowes, BS
From the Michael S. Aldrich Sleep Disorders Laboratory, Department of Neurology, University of Michigan Medical School, Ann Arbor.


Address correspondence and reprint requests to Dr. Beth A. Malow, Michael S. Aldrich Sleep Disorders Laboratory, UH Room 8D-8702, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0117; email: [email protected]

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