Jo Hyunjin, Choi Sujung, Kim Dongyeop, Joo Eunyeon
Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Korea.
Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul 06355, Korea.
J Clin Med. 2022 Apr 6;11(7):2063. doi: 10.3390/jcm11072063.
Purpose: To compare the characteristics of obstructive sleep apnea (OSA) between patients with epilepsy and patients without epilepsy and to investigate CPAP (Continuous Positive Airway Pressure) effect on seizures. Methods: Medical and polysomnography (PSG) data from 235 adult OSA patients with epilepsy (OE; 183 males; mean age, 49.8 years) and 268 age- and sex-matched OSA patients without epilepsy (OSE; 216 males; mean age, 51.3 years), obtained between March 2014 and May 2020 and housed in a database in a university-affiliated hospital, were retrospectively reviewed. All subjects completed surveys addressing comorbidities and medications, and sleep-related questionnaires including the Insomnia Severity Index, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Beck Depression Inventory-II. Results: Compared with the OSE group, the OE group reported fewer sleep-related complaints and less severe OSA-related PSG parameters, with a lower apnea-hypopnea index (24.9 vs. 33.4 events/h; p < 0.003), arousal index (23.3 vs. 30.8 events/h; p < 0.001), and oxygen desaturation index (19.6 vs. 28.8; p < 0.002). The OE group had fewer smokers and lower alcohol consumption but a higher body mass index (27.0 vs. 25.9 kg/m2; p < 0.001). No correlations were observed between OSA-related PSG parameters and epilepsy-related factors, such as age at seizure onset, seizure type, frequency of seizures, presence of nocturnal seizures, and number of antiseizure medications, in the OE group. Patients with OE who demonstrated good compliance with CPAP therapy exhibited a decrease in seizure frequency. Conclusions: The OE group exhibited less severe disease characteristics than their age- and sex-matched OSE counterparts. Nevertheless, because the coexistence of OSA and epilepsy is high, CPAP therapy can reduce the frequency of seizures. Therefore, it is important to evaluate the presence of OSA in patients with epilepsy and to treat the conditions concurrently.
比较癫痫患者与非癫痫患者阻塞性睡眠呼吸暂停（OSA）的特征，并研究持续气道正压通气（CPAP）对癫痫发作的影响。方法：回顾性分析2014年3月至2020年5月期间在一所大学附属医院数据库中获取的235例成年癫痫合并OSA患者（OE组；183例男性；平均年龄49.8岁）和268例年龄及性别匹配的非癫痫OSA患者（OSE组；216例男性；平均年龄51.3岁）的医学和多导睡眠图（PSG）数据。所有受试者均完成了关于合并症和用药情况的调查，以及包括失眠严重程度指数、爱泼华嗜睡量表、匹兹堡睡眠质量指数和贝克抑郁量表第二版在内的与睡眠相关的问卷调查。结果：与OSE组相比，OE组报告的睡眠相关主诉较少，OSA相关的PSG参数较轻，呼吸暂停低通气指数较低（24.9次/小时对33.4次/小时；p<0.003），觉醒指数较低（23.3次/小时对30.8次/小时；p<0.001），氧饱和度下降指数较低（19.6对28.8；p<0.002）。OE组吸烟者较少，酒精摄入量较低，但体重指数较高（27.0kg/m²对25.9kg/m²；p<0.001）。在OE组中，未观察到OSA相关的PSG参数与癫痫相关因素之间的相关性，如癫痫发作起始年龄、癫痫发作类型、癫痫发作频率、夜间癫痫发作的存在情况以及抗癫痫药物的数量。对CPAP治疗依从性良好的OE患者癫痫发作频率降低。结论：与年龄及性别匹配的OSE组相比，OE组疾病特征较轻。然而，由于OSA和癫痫的共存率较高，CPAP治疗可降低癫痫发作频率。因此，评估癫痫患者中OSA的存在并同时治疗这两种疾病很重要。
