Abstracts

Rationale: To investigate the prevalence of sleep-disordered breathing in patients with epilepsy, psychogenic non-epileptic seizures (PNES), or both disorders admitted for prolonged video-EEG monitoring. Methods: A cross-sectional study examining the prevalence of sleep-disordered breathing in patients admitted for prolonged video-EEG monitoring between December 2011 and June 2017 was conducted. Only patients with a diagnosis of epilepsy or PNES were enrolled in this study. Patients who had previously received a diagnosis of obstructive sleep apnea (OSA) or who were already treated with continuous positive airway pressure were excluded from this study. Patients underwent routine diagnostic polysomnography and neurocognitive testing, and completed screening instruments of quality of life, perceived sleep quality and daytime somnolence during their monitoring period. Studies were staged and scored in accordance with the current American Academy of Sleep Medicine guidelines. Results: A total of 316 patients who received a diagnosis of epilepsy (n=222), PNES (n=74), or both (n=20) were assessed. The prevalence of sleep-disordered breathing was high in the entire cohort, with 195 (61.7%) patients meeting the diagnostic criteria for mild OSA. Moderate-severe OSA was diagnosed in 84 (26.6%) patients. Patients with PNES had the highest prevalence of moderate-severe sleep disordered breathing (31.1%), followed by those with epilepsy (26.6%), and those with both disorders (10%). There were no significant differences in measures of cognition and quality of life across the groups. Conclusions: This study reports a high prevalence of OSA in a population with undiagnosed sleep-disordered breathing. Routine polysomnography is an effective diagnostic tool in patients admitted for video-EEG monitoring. Further studies examining treatment and seizure frequency are required. Studies examining the prevalence and severity of OSA and associated hypoxemia, as well as other cardiovascular comorbidities are warranted. Funding: TO receives funding from the National Health and Medical Research Council (NHMRC) Program Grant. TO, PK and SS receive funding from The Royal Melbourne Hospital Neuroscience Foundation. PP is supported by the Melbourne International Research Scholarship (MIRS) and the Melbourne International Fee Remission Scholarship (MIFRS) from the University of Melbourne.