Türk Uyku Tıbbı Dergisi (Dec 2020)

Effects of Positive Airway Pressure Therapy on Seizure Control in Patients with Nocturnal Epilepsy and Obstructive Sleep Apnoea Syndrome

  • Gülçin Benbir Şenel,
  • Derya Karadeniz

DOI
https://doi.org/10.4274/jtsm.galenos.2020.08370
Journal volume & issue
Vol. 7, no. 1
pp. 24 – 28

Abstract

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Objective:Obstructive Sleep Apnoea syndrome (OSAS) is common in patients with epilepsy. A reduction in seizure frequency was reported following positive airway pressure (PAP) therapy. Thus, changes in seizures and related factors have been studied in patients with nocturnal epilepsy and OSAS.Materials and Methods:All patients with nocturnal epilepsy admitted to our sleep and disorders unit were evaluated consecutively for the last 5 years.Results:Of the 58 patients with nocturnal epilepsy and OSAS, 74.1% were male. The mean age was 48.6±14.3 years, and disease duration was 10.1±10.6 years. Moreover, 34 (58.7%) patients underwent successful PAP therapy. Conversely, seizures persisted or increased in 18 (31.0%) patients and decreased in 14 (24.2%), whereas 26 (44.8%) patients were seizure-free. Gender (p=0.773) and age (p=0.998) were not related to changes in seizure frequency. However, decrease in seizures was more common in patients with a shorter disease duration (p=0.032), higher number of seizures (p=0.027) and abnormality in electroencephalography (p=0.005). Sleep efficiency (p=0.468), slowwave sleep duration (p=0.264), or rapid eye movement sleep (p=0.238) was found to be unrelated. In patients without any decrease in seizures, the Apnoea-hypopnoea index was higher but not significant (p=0.160), whereas oxygen saturation level was significantly lower (p=0.037). Decrease in seizures was present in 71.9% of the patients under successful PAP therapy but in 66.7% of patients with non-compliance, although this disparity was not statistically significant (p=0.351).Conclusion:A decrease in seizures was associated with a shorter duration of epilepsy, higher number of seizures and abnormality in electroencephalography. Although the reduction in seizures was more prominent in patients with successful PAP therapy, this was not statistically significant.

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