title: Routine polysomnography in an epilepsy monitoring unit.
abstract: Up to 13% of patients with epilepsy have moderate or severe sleep-disordered breathing, in particular obstructive sleep apnea (OSA), a disorder associated with reduced quality of life, worsened seizure control, and increased cardiovascular morbidity and mortality. Combining video-EEG monitoring with polysomnography (VPSG) provides the opportunity to diagnose clinically significant OSA as well as relate the occurrence of seizures and the epilepsy diagnosis to the presence and severity of sleep-disordered breathing. We have established routine VPSG in our inpatient video-EEG monitoring unit and present our findings in 87 patients. Clinically significant sleep-disordered breathing was diagnosed in 19 of 87 (22%) patients. Patients with psychogenic non-epileptic seizures (PNES) had poorer sleep quality compared to patients with epilepsy and those with neither diagnosis, whereas the prevalence of clinically significant sleep-disordered breathing in patients with PNES (29%) did not differ significantly compared to patients with epilepsy (21%) and those with neither diagnosis (22%). The differences in sleep quality are not explained by differences in body mass index (BMI) or anti-epileptic drug (AED) effects.
authors.affiliation: Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia. mclphillips@hotmail.com
authors.forename: Matthew C L
authors.initials: MC
authors.lastname: Phillips
authors.forename: Craig A
authors.initials: CA
authors.lastname: Costello
authors.forename: Elise J
authors.initials: EJ
authors.lastname: White
authors.forename: Michelle
authors.initials: M
authors.lastname: Smit
authors.forename: John
authors.initials: J
authors.lastname: Carino
authors.forename: Andrew
authors.initials: A
authors.lastname: Strawhorn
authors.forename: Brianna
authors.initials: B
authors.lastname: Jackson
authors.forename: Patrick
authors.initials: P
authors.lastname: Kwan
authors.forename: Christopher R
authors.initials: CR
authors.lastname: French
authors.forename: S Raju
authors.initials: SR
authors.lastname: Yerra
authors.forename: K Meng
authors.initials: KM
authors.lastname: Tan
authors.forename: Terence J
authors.initials: TJ
authors.lastname: O'Brien
authors.forename: Jeremy
authors.initials: J
authors.lastname: Goldin
mesh_terms: D000328:Adult; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology*; D014741:Video Recording
keywords: Epilepsy; Obstructive sleep apnea (OSA); Polysomnography; Psychogenic non-epileptic seizures (PNES); Video-EEG