Treating obstructive sleep apnea in adults with epilepsy: a randomized pilot trial

Area of Science:

• Neurology
• Sleep Medicine
• Pulmonology

Background:

• Obstructive sleep apnea (OSA) is common in epilepsy.
• Limited data suggests OSA treatment may improve seizure control.

Purpose of the Study:

• To address critical design issues for a definitive randomized controlled trial.
• To assess the feasibility of treating OSA in epilepsy patients.

Main Methods:

• Pilot randomized controlled trial in adult patients with refractory epilepsy and OSA.
• Randomization to therapeutic or sham continuous positive airway pressure (CPAP).
• Seizure calendars and stable antiepileptic drug dosages were maintained.

Main Results:

• 35 subjects randomized; 22 to therapeutic CPAP, 13 to sham CPAP.
• Therapeutic CPAP significantly reduced apnea-hypopnea index (AHI) compared to sham.
• Blinding was successful; participants and investigators could not predict treatment allocation.

Conclusions:

• This pilot study provided crucial feasibility and design data.
• Informs planning for a comprehensive trial on OSA treatment in epilepsy.
• Supports further investigation into the link between OSA and seizure control.