Central sleep apnea and complex sleep apnea in patients with epilepsy

Sleep Breath. 2014 Mar;18(1):119-24. doi: 10.1007/s11325-013-0858-8. Epub 2013 May 1.

Abstract

Purpose: We sought to examine the prevalence of central sleep apnea (CSA) and complex sleep apnea (CompSA) in patients with epilepsy and to examine their clinical profile, with respect to epilepsy type, etiology, medication use, and EEG abnormalities.

Methods: We undertook a retrospective analysis of 719 consecutive patients with epilepsy who underwent polysomnography (PSG) at our institution between 2004 and 2011. Of the 458 patients with complete data, we excluded 42 patients with congestive heart failure or left ventricular ejection fraction <40 %. Comparison of clinical and PSG variables between the three groups were conducted with Fisher exact test and analysis of variance.

Results: Out of 416 patients tested, 315 (75 %) had obstructive sleep apnea (OSA), 16 (3.7 %) had CSA, 33 (7.9 %) had CompSA. There were more males in the CSA and CompSA groups than in the OSA group (81.2, 81.8, and 59.6 %, respectively, p=0.04). Focal seizures were more prevalent in patients with CSA than in patients OSA or CompSA (62.5, 265, and 21.1 %, respectively, p=0.02).

Conclusion: About 11 % of epilepsy patients have sleep-breathing disorders with central apneas, which is not higher than that in a general population. These data should be expanded with future research investigating the role of interictal, ictal, and postictal central apneas in epileptogenesis and epilepsy.

MeSH terms

  • Adult
  • Aged
  • Anticonvulsants / therapeutic use
  • Comorbidity
  • Continuous Positive Airway Pressure
  • Cross-Sectional Studies
  • Epilepsies, Partial / diagnosis
  • Epilepsies, Partial / epidemiology
  • Epilepsies, Partial / therapy
  • Epilepsy / diagnosis*
  • Epilepsy / epidemiology*
  • Epilepsy / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polysomnography
  • Retrospective Studies
  • Risk Factors
  • Sleep Apnea Syndromes / diagnosis*
  • Sleep Apnea Syndromes / epidemiology*
  • Sleep Apnea Syndromes / therapy
  • Sleep Apnea, Central / diagnosis*
  • Sleep Apnea, Central / epidemiology*
  • Sleep Apnea, Central / therapy
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / therapy
  • Statistics as Topic

Substances

  • Anticonvulsants