Abstracts

Rationale: Obstructive sleep apnea (OSA) is prevalent in patients with epilepsy. However, no study to date has distinguished OSA risk between patients with Localization-Related Epilepsy (LRE) vs Generalized Epilepsy (GE). The objective of this study was to determine if patients with localization-related epilepsy (LRE) or generalized epilepsy (GE) are at similar risk for obstructive sleep apnea (OSA) by using validated questionnaires that screen for OSA in epilepsy patients. Methods: Adult patients meeting inclusion criteria at an academic epilepsy center were prospectively recruited for this study. They completed a Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ), Epworth Sleepiness Scale (ESS) and provided consent for epilepsy and other health history to be studied. Epilepsy classification was made by the attending epileptologist based on clinical history and exam, electroencephalogram and radiographic imaging. Demographic information, risk factors for OSA, diagnosis of OSA, type of epilepsy, seizure frequency, and number of antiepileptic drugs (AEDs) were extracted from the electronic medical record. Results: Eighty-four patients (65 LRE, 19 GE) were recruited. Of the baseline characteristics, only age was different between patients with LRE vs. GE (44.8 ± 15.9 yrs vs. 32.0 ± 13.2 yrs, respectively, p = 0.002). Number of AEDs, seizures within the last month and seizures within the last 6 months were similar between the two groups.  There was a trend for ESS to be higher for patients with GE compared to those with LRE but this did not reach statistical significance (mean ± standard deviation: 8.3 ± 3.5 vs. 6.6 ± 4.6, p = 0.14).  SA-SDQ scores were similar for the LRE and GE patients (24.7 ± 7.7 vs 25.2 ± 7.2, respectively, p = 0.83).  The proportion of patients with ESS scores concerning for excessive daytime sleepiness (ESS = 10) did not differ between the LRE and GE patients (20 vs. 32%, p = 0.29).  The proportion of patients with SA-SDQ scores concerning for moderate-severe sleep apnea (SA-SDQ = 26 in females and  = 29 in males) did not differ between LRE and GE patients (36 vs. 37%, p = 0.91).  Age and ESS were not correlated (p = 0.71). Conclusions: These results suggest that SA-SDQ and ESS scores are similar in patients with LRE and GE recruited for this study.  Although there was a trend for ESS to be higher in GE compared to LRE patients, this did not reach statistical significance.  Additionally, there was no difference by epilepsy type with regards to proportion of patients with an ESS or SA-SDQ score most concerning for moderate-severe OSA.  Whether similar scores on these questionnaires reflect a similar risk for OSA in these patients or rather reflect limitations of these questionnaires will need to be determined with objective testing. Funding: Not applicable