title: Sleep apnea and epilepsy: who's at risk?
abstract: Obstructive sleep apnea (OSA) is highly prevalent, affecting 25% of men and 10% of women. Treatment reduces seizures in some patients. Awareness of the comorbidity of sleep disturbances in epilepsy has been increasing. No study has explored OSA predictors in patients unselected for epilepsy severity and sleep disorder symptoms. We assessed cross-sectional OSA prevalence and predictors (apnea-hypopnea index [AHI] ≥10) in 130 consecutive adults using structured interview, subjective assessments, and polysomnography. Obstructive sleep apnea prevalence was 30%, 16% having moderate-severe disease, rates that markedly exceed general population estimates. Obstructive sleep apnea predictors in multivariate modeling included age, dental problems, and standardized AED dose. Male gender, older age, higher BMI, hypertension, and dental problems were associated with higher AHI. Adults with epilepsy appear at increased risk for OSA, increasing with age and AED load, regardless of gender, BMI, and seizure frequency. These findings support the implementation of routine OSA screening in adult epilepsy clinics.
authors.affiliation: Sleep Disorders and Epilepsy Centers, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA. foldvan@ccf.org
authors.forename: Nancy
authors.initials: N
authors.lastname: Foldvary-Schaefer
authors.forename: Noah D
authors.initials: ND
authors.lastname: Andrews
authors.forename: Darakul
authors.initials: D
authors.lastname: Pornsriniyom
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Moul
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Sun
authors.forename: James
authors.initials: J
authors.lastname: Bena
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult