Obstructive sleep apnea in drug-resistant epilepsy: A significant comorbidity warranting diagnosis and treatment

Dinkelacker, Vera

doi:10.1016/j.neurol.2016.03.007

Cited by 8 publications

(2 citation statements)

References 109 publications

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“…6 Epilepsy has been associated with obstructive sleep apnea (OSA), a sleep-breathing disorder where breathing involuntarily lapses during sleep. 7,8 In addition, VNS use has been linked with OSA and respiratory complications. 9,10 The effect of VNS on the quality of sleep among patients with epilepsy has not been extensively studied, although some existing studies have found a reduced quality of sleep and more patients diagnosed with OSA after VNS implantation.…”

Section: Introductionmentioning

confidence: 99%

“…Lower quality of sleep leads to excessive daytime sleepiness, impaired memory and learning, and reduced quality of life 6 . Epilepsy has been associated with obstructive sleep apnea (OSA), a sleep‐breathing disorder where breathing involuntarily lapses during sleep 7,8 . In addition, VNS use has been linked with OSA and respiratory complications 9,10 …”

Section: Introductionmentioning

confidence: 99%

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Effects of vagus nerve stimulation on the quality of sleep and sleep apnea in patients with drug‐resistant epilepsy: A systematic review

Seth,

Couper,

Burneo

et al. 2023

Epilepsia

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ObjectiveThe objective was to systematically evaluate the current evidence surrounding the effect of vagus nerve stimulation (VNS) on quality of sleep and obstructive sleep apnea (OSA) among patients with epilepsy.MethodsA literature search was conducted using the Embase and MEDLINE databases. Studies were included if they involved patients with drug‐resistant epilepsy treated with VNS and used validated tools to report on quality of sleep or sleep apnea. The literature search yielded 112 citations related to VNS and sleep quality, and 82 citations related to sleep apnea. Twelve articles were included in the review, of which five measured quality of sleep among patients who underwent VNS, six studies measured sleep apnea, and one study measured both outcomes.ResultsStudies measuring quality of sleep used different methods, including sleep quality questionnaires and the percentage of sleep in each cycle. Studies also varied in patient populations, the use of control groups, and whether multiple measurements were taken for each patient. Some studies found improved sleep quality after VNS, whereas others found reductions in deep sleep stages. Additionally, mixed results in sleep quality were found when comparing patients with epilepsy who received VNS treatment versus patients with epilepsy who did not receive VNS treatment. Variables such as VNS intensity and age could potentially confound quality of sleep. Studies measuring sleep apnea consistently found increased proportions of patients diagnosed with OSA or increased sleep index scores after VNS implantation.SignificanceOverall, the effect of VNS on quality of sleep remains unclear, as studies were very heterogeneous, although the effect on sleep apnea has consistently shown an increase in sleep apnea severity indices after VNS implantation. Future studies with consistent measures and discussions of confounding are required to determine the effect of VNS on quality of sleep, and the effect of VNS parameters should be further explored among patients who develop sleep apnea.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of vagus nerve stimulation on the quality of sleep and sleep apnea in patients with drug‐resistant epilepsy: A systematic review

Seth,

Couper,

Burneo

et al. 2023

Epilepsia

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Schlaf und Epilepsie

Schiefer

2017

Z. Epileptol.

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Neurological Deficits in Obstructive Sleep Apnea

Ferini‐Strambi

Lombardi

Marelli

et al. 2017

Curr Treat Options Neurol

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Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive episodes of complete or partial obstruction of the upper airway. The prevalence of this disorder is strictly dependent on its gravity. At ≥15 events/h apnea-hypopnea index (AHI), it ranges from 6 to 17% in the general population, with higher rates in men and increasing with age. The hypoxia induced by OSA severely affects the structure and function of blood vessels, culminating in mortality and morbidity. Its negative impact influences also cognitive functioning. Recent papers showed the relationship between OSA and some neurological disorders, such as neurodegenerative diseases, stroke, epilepsy, and headache. OSA may accelerate the onset of mild cognitive impairment and Alzheimer's disease (AD) and might also represent an independent risk factor for Parkinson's disease (PD). OSA is also frequent in multisystem atrophy. In the early stages of AD, continuous positive airway pressure (CPAP) treatment might slow down the progression of the disease, thus highlighting the potential importance of OSA screening and a timely intervention in these patients. Moreover, CPAP is effective in reducing daytime sleepiness in PD. OSA may induce seizures by means of sleep disruption and deprivation, as well as cerebral hypoxemia with consequent oxidative stress. It has been demonstrated that CPAP treatment is efficacious in controlling epileptic seizures. OSA can represent a risk factor for stroke and death, mainly related to the endothelial dysfunction, with the formation of atherosclerosis caused by hypoxia through oxidative stress. CPAP treatment in patients with OSA and stroke, if delivered in the early stages, is able to increase the magnitude of neurologic improvement after the vascular accident. There is a strong association between OSA and headache. In particular, there is a "sleep apnea headache" described as a recurrent morning headache, with resolution after effective treatment of sleep apnea. This review clearly shows the importance of taking a sleep history in neurological patients and considering the diagnosis and specific treatment of OSA in these patients.

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Obstructive sleep apnea in drug-resistant epilepsy: A significant comorbidity warranting diagnosis and treatment

Cited by 8 publications

References 109 publications

Effects of vagus nerve stimulation on the quality of sleep and sleep apnea in patients with drug‐resistant epilepsy: A systematic review

Effects of vagus nerve stimulation on the quality of sleep and sleep apnea in patients with drug‐resistant epilepsy: A systematic review

Schlaf und Epilepsie

Neurological Deficits in Obstructive Sleep Apnea

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