Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy.
BACKGROUND
Although epileptic seizures occur more commonly in older adults, their occurrence in this age group is often unexplained. One unexplored precipitant of seizures in older adults is obstructive sleep apnea (OSA), which is also more common in this age group. Our objective was to investigate whether OSA is associated with seizure exacerbation in older adults with epilepsy.


METHODS
Polysomnography was performed in older adult patients with late-onset or worsening seizures (Group 1, n = 11) and those who were seizure-free or who had improvement of seizures (Group 2, n = 10).


RESULTS
Patients in Group 1 had a significantly higher apnea-hypopnea index than patients in Group 2 (p = 0.002). Group 1 patients also had higher Epworth Sleepiness Scale scores (p = 0.009) and higher scores on the Sleep Apnea Scale of the Sleep Disorders Questionnaire (p = 0.04). The two groups were similar in age, body mass index, neck circumference, number of antiepileptic drugs currently used, and frequency of nocturnal seizures.


CONCLUSIONS
Obstructive sleep apnea is associated with seizure exacerbation in older adults with epilepsy, and its treatment may represent an important avenue for improving seizure control in this population.
Chihorek
Annette M
AM
Department of Neurology, Sleep Disorders Division, Vanderbilt University School of Medicine, Nashville, TN 37232-2551, USA.
Abou-Khalil
Bassel
B
Malow
Beth A
BA
D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000375:Aging / Q000502:physiology*; D000927:Anticonvulsants / Q000627:therapeutic use; D015992:Body Mass Index; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011795:Surveys and Questionnaires
D000927:Anticonvulsants