EMBARGOED FOR RELEASE:
Dec. 2, 2017
WASHINGTON, D.C. – Common treatment for obstructive sleep apnea (OSA) may decrease the
risk of seizures in people with epilepsy who also suffer from the sleep disorder, suggests
research being presented at the American Epilepsy Society 71st Annual Meeting.
In people with OSA, the tongue and soft palate collapse against the back of the throat during
sleep, which interrupts breathing. This leads to poor quality sleep and increases the risk for
high blood pressure, heart attacks and strokes. In people with OSA who also have epilepsy,
the lack of quality sleep increases the risk for seizures.
The most successful treatment for OSA is positive airway pressure (PAP) therapy, in which a
mask is fitted over the nose and sometimes the mouth, and air is gently blown into the airway
to keep it open during sleep.
“Sleep apnea is common in people with epilepsy, but few physicians screen for it,” said
Thapanee Somboon, M.D., lead author and research fellow at the Sleep Disorders Center at
Cleveland Clinic. “All patients with epilepsy should be checked for sleep disorders, including
insomnia and sleep apnea, because there are effective treatments.”
The study – the largest to focus on the effectiveness of PAP in reducing seizures in people
with OSA and epilepsy – included 197 people with epilepsy, 75 who did not have OSA and 122
who did. Of those with OSA, 73 used PAP and 49 did not. At one year, 63 percent of people
treated with PAP reported a 50 percent or greater reduction in seizures from baseline (before
the study began), compared to 14 percent of those who weren’t treated and 44 percent of
those who did not have OSA. Researchers also assessed overall outcome success, defined as
not having seizures at baseline and remaining seizure-free for a year, or having seizures at
baseline but reporting a 50 percent or greater reduction in seizures over one year.
Researchers reported successful outcomes in 85 percent of those who were treated, 55
percent of those who were untreated and 65 percent of those who did not have OSA.
OSA causes sleep deprivation, which increases the chance of seizures occurring, although
researchers aren’t sure why. Many people with epilepsy take antiepileptic drugs (AEDs), and
these may increase the risk of OSA, because the drugs relax upper respiratory muscles and
may cause weight gain, another risk factor for OSA. OSA is diagnosed via medical history,
physical exam and a sleep study, in which the person’s sleep is monitored.
Although there is increasing recognition of the OSA-epilepsy relationship, it remains
overlooked by many doctors.
There are a variety of treatments for OSA, including losing weight, taking a decongestant,
wearing a special mouth guard to bed and having surgery. PAP is the most effective treatment
for people with moderate to severe OSA.
“Unfortunately, many people with epilepsy don’t realize they have sleep apnea,” said Dr.
Somboon. “Being diagnosed is the first step towards getting effective treatment and
potentially decreasing the risk of seizures.”