Identification and treatment of obstructive sleep apnea in adults and children with epilepsy: a prospective pilot study.

Malow BA, Weatherwax KJ, Chervin RD, Hoban TF, Marzec ML, Martin C, Binns LA
Sleep Med. 2003 4 (6): 509-15

PMID: 14607344

OBJECTIVE - To determine the effect of treating obstructive sleep apnea (OSA) on seizure frequency in adults and children with epilepsy in a prospective study. Several case series documented an improvement in seizure control with treatment of coexisting OSA, but published series did not sample a clinic population, were not prospective in design, and did not account for concurrent changes in antiepileptic drug (AED) doses or levels.

PATIENTS AND METHODS - Adult patients and the parents of pediatric patients seen in the University of Michigan Epilepsy and Pediatric Neurology Clinics were given validated questionnaires. Thirteen adults (aged 20-56) and 5 children (aged 14-17) were selected for polysomnography (PSG) based on frequency of seizures and risk for OSA. Seizure frequency was compared during 8-week baseline and treatment phases and AED levels were done to document stability in medication levels.

RESULTS - Six of 13 adults and 3 of 5 children met PSG criteria for OSA. Three adults and 1 child were treated with continuous positive airway pressure (CPAP), were tolerant of the device, and had no change in AED doses; all four had at least a 45% reduction in seizure frequency during CPAP treatment. One adult was treated with an oral appliance with a reduction in nocturnal seizures only, and 2 adults and 2 children were intolerant of CPAP.

CONCLUSIONS - Treatment of OSA in patients with epilepsy may improve seizure control and a large randomized placebo-controlled trial appear warranted.

MeSH Terms (13)

Adolescent Adult Child Child, Preschool Epilepsy Humans Pilot Projects Polysomnography Positive-Pressure Respiration Prospective Studies Severity of Illness Index Sleep Apnea, Obstructive Surveys and Questionnaires

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