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Epilepsy and sleep apnea syndrome
O Devinsky1, B Ehrenberg, G M Barthlen
1Department of Neurology, New York University Medical Center, Hospital for Joint Diseases, New York.
Neurology
|November 1, 1994
Summary
Treating sleep apnea in epilepsy patients can reduce seizures. Interventions like CPAP improved seizure control in most patients, highlighting the link between sleep disorders and epilepsy management.
Area of Science:
- Neurology
- Sleep Medicine
- Pulmonology
Background:
- Refractory partial epilepsy and sleep apnea often coexist.
- Sleep apnea is a potential exacerbating factor in epilepsy.
Observation:
- Seven patients with refractory partial epilepsy and comorbid sleep apnea were studied.
- Risk factors for sleep apnea include obesity, habitual snoring, and daytime somnolence.
Findings:
- Treatment of sleep apnea with nasal continuous positive airway pressure (CPAP), protriptyline, trazodone, acetazolamide, or tracheostomy reduced seizure frequency and severity in six of seven patients.
- CPAP compliance was crucial for success, with four of five patients showing reduced seizures.
- Sleep apnea may worsen epilepsy through sleep disruption, hypoxemia, and reduced cerebral blood flow.
Implications:
- Identifying and treating sleep apnea in epilepsy patients can improve seizure control.
- Polysomnography is recommended for epilepsy patients with sleep apnea risk factors.
- Addressing sleep disorders is a key component of comprehensive epilepsy care.