Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment

Abstract

Epilepsy is a group of neurological conditions in which there is a pathological and enduring predisposition to generate recurrent seizures. Evidence over the last few decades suggests that epilepsy may be associated with increased sleep-disordered breathing, which may contribute towards sleep fragmentation, daytime somnolence, reduced seizure control, and cardiovascular-related morbidity and mortality. Chronic sleep-disordered breathing can result in loss of gray matter and cause deficits to memory and global cognitive function. Sleep-disordered breathing is a novel and independent predictor of sudden cardiac death and, as such, may be involved in the mechanisms leading to sudden unexpected death in epilepsy. Despite this, the long-term consequences of sleep-disordered breathing in epilepsy remain unknown, and there are no guidelines for screening or treating this population. There is currently insufficient evidence to indicate continuous positive airway pressure (CPAP) for the primary or secondary prevention of cardiovascular disease, and recent evidence has failed to show any reduction of fatal or nonfatal cardiovascular endpoints. Treatment of sleep-disordered breathing may potentially improve seizure control, daytime somnolence, and neurocognitive outcomes, but few studies have examined this relationship. In this review, we examine sleep-disordered breathing in epilepsy, and discuss the potential effect of epilepsy treatments. We consider the role of CPAP and other interventions for sleep-disordered breathing and discuss their implications for epilepsy management.

Patterns of daily activity among young people with epilepsy

“…Young people with epilepsy have been recognized to be at increased risk of impaired mental health, functioning, and social adjustment . The fact that over 99% of Canadian young people with epilepsy attending public school do not adhere simultaneously to all three of the recommendations probably increases their risks for obesity, sleep apnea, fatty liver, poor bone health, social disability, and poorer quality of life…”

“…24 Young people with epilepsy have been recognized to be at increased risk of impaired mental health, functioning, and social adjustment. 25,26 The fact that over 99% of Canadian young people with epilepsy attending public school do not adhere simultaneously to all three of the recommendations probably increases their risks for obesity, 27 sleep apnea, 28 fatty liver, 29 poor bone health, 30 social disability, 25 and poorer quality of life. 31 These empirical data imply that there is a need for targeted interventional studiesstudies that would introduce strategies to improve adherence to the 24-hour behavioural guidelines combined with long-term follow-up measures to identify changes leading to secondary comorbidities in adolescence and later as adults.…”

Dietary Flavonoids Interaction with CREB-BDNF Pathway: An Unconventional Approach for Comprehensive Management of Epilepsy

“…*Address correspondence to this author at the Pharmacology and Toxicology Laboratory, CSIR-Institute of Himalayan Bioresource Technology, Palampur-176061, Himachal Pradesh, India; Tel: +91-9417923132; E-mails: dsinghpharmacology@gmail.com, damanpreet@ihbt.res.in Epilepsy can occur at any age but is highly prevalent in children and elderly population. In general population the prevalence of epilepsy is estimated to be 6.4 per 1,000 whereas the lifetime or cumulative incidence rate is 7.6 per 1,000 [4].…”

Measuring Sleep, Wakefulness, and Circadian Functions in Neurologic Disorders

“…76 Moderate to severe SDB affects up to 26.5% of epileptic patients and may increase seizure frequency. 78 These findings highlight the importance of SWCD diagnosis and treatment in epilepsy management. In addition, several epilepsy syndromes show seizure activity exclusively or predominantly in sleep.…”