Obstructive sleep apnea in a clinical series of adult epilepsy patients: frequency and features of the comorbidity.
OBJECTIVE
The aim of this study was to evaluate the rate and features of obstructive sleep apnea (OSA) in adult epilepsy patients.


METHODS
Two hundred eighty-three adult epilepsy patients (137 men; mean age, 33 years; range, 18-70 years) were prospectively screened for OSA by means of a structured interview. Those in whom OSA was clinically suspected were monitored for a full night by using a portable device (Polymesam), and OSA was diagnosed when they had an Apnea/Hypopnea Index greater than five.


RESULTS
Coexistence of OSA with epilepsy was found in 10.2% (15.4% of the male and 5.4% of the female) epilepsy patients investigated. The OSA was mild in 66.6%, moderate in 22.2%, and severe in 11.1% of the cases. The "epilepsy + OSA" patients were older, heavier, more frequently male, and sleepier (p < 0.05) than those with "epilepsy only." Furthermore, they experienced their first seizure at an older age (p < 0.05).


CONCLUSIONS
Systematic investigation reveals that OSA is frequent in epilepsy patients. The major risk factors for OSA in our epilepsy patients were the same as those typically found in the general population. Of the epilepsy-related factors, older age at onset of seizures appears to be significantly related to comorbidity with OSA (p < 0.05). The presence in epilepsy patients of these features should alert the clinician to the possibility of an underlying OSA.
Manni
Raffaele
R
Unit of Sleep Medicine and Epilepsy, C Mondino Institute of Neurology, Pavia, Italy. raffaele.manni@mondino.it
Terzaghi
Michele
M
Arbasino
Carla
C
Sartori
Ivana
I
Galimberti
Carlo Andrea
CA
Tartara
Amelia
A
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D015897:Comorbidity; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*