Avital Dekel, Noyman Iris, Bistritzer Jacob, Goldbart Aviv, Hazan Guy, Langman Yasmine, Ziv Oren, Hazan Itai, Golan-Tripto Inbal
Pediatric Neurology Unit, Saban Pediatric Medical Center, Soroka University Medical Center, Beer-Sheva, Israel.
Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Pediatr. 2025 Apr 3;184(5):278. doi: 10.1007/s00431-025-06105-9.
The purpose of the study is to evaluate the prevalence of epilepsy in children with surgically treated obstructive sleep apnea (OSA) and examine the associated healthcare utilization. This cross-sectional study included children aged 1-18 years diagnosed with moderate to severe OSA who were treated with adenoidectomy or adenotonsillectomy. A matched control group (1:3 ratio) without OSA was used for comparison. Data were obtained from Clalit Health Services, Israel's largest healthcare provider. The study analyzed the prevalence of epilepsy, hospital admissions for seizures, use of anti-seizure medications (ASMs), and outpatient visits to pediatric neurologists. Among 55,164 children (13,791 in the OSA group and 41,373 in the control group), the prevalence of epilepsy was higher in the OSA group (0.9% vs. 0.4%; odds ratio (OR) = 2.22, p < 0.001). The OSA group also exhibited higher rates of ASM use (1.1% vs. 0.5%; OR = 2.24, p < 0.001), emergency department visits (OR = 15.66, p < 0.001), hospital admissions (OR = 3.18, p < 0.001), and visits to pediatric neurologists (14% vs. 8.1%; OR = 1.85, p < 0.001). The usage of ASMs was significantly higher in the OSA group, particularly for levetiracetam (OR = 3.73, p < 0.001).
Children with surgically treated OSA had higher rates of epilepsy and greater healthcare utilization compared to their peers. These findings underscore the necessity for integrated care, including neurological assessments, for children with OSA. Further research is needed to examine the impact of OSA treatment on epilepsy outcomes.
• Obstructive sleep apnea (OSA) and epilepsy are prevalent neurological conditions in children, with evidence suggesting a bidirectional relationship between sleep disorders and epilepsy in adults. • OSA prevalence is notably higher in children with refractory epilepsy or those prescribed multiple anti-seizure medications (ASMs).
• This study demonstrates a twofold increase in epilepsy prevalence among children with surgically treated moderate-to-severe OSA compared to matched controls. • Pediatric patients with OSA exhibit significantly higher rates of epilepsy-related healthcare utilization, including hospital admissions, emergency visits, and consultations with pediatric neurologists.
本研究的目的是评估接受手术治疗的阻塞性睡眠呼吸暂停（OSA）儿童的癫痫患病率，并检查相关的医疗保健利用情况。这项横断面研究纳入了1至18岁被诊断为中度至重度OSA并接受腺样体切除术或腺样体扁桃体切除术的儿童。使用一个无OSA的匹配对照组（1:3比例）进行比较。数据来自以色列最大的医疗服务提供商Clalit Health Services。该研究分析了癫痫患病率、癫痫发作的住院情况、抗癫痫药物（ASM）的使用情况以及儿科神经科医生的门诊就诊情况。在55164名儿童中（OSA组13791名，对照组41373名），OSA组的癫痫患病率更高（0.9%对0.4%；优势比（OR）=2.22，p<0.001）。OSA组的ASM使用率也更高（1.1%对0.5%；OR=2.24，p<0.001）、急诊科就诊率（OR=15.66，p<0.001）、住院率（OR=3.18，p<0.001）以及儿科神经科医生的就诊率（14%对8.1%；OR=1.85，p<0.001）。OSA组的ASM使用显著更高，尤其是左乙拉西坦（OR=3.73，p<0.001）。
与同龄人相比，接受手术治疗的OSA儿童的癫痫发病率更高，医疗保健利用率更高。这些发现强调了对OSA儿童进行综合护理（包括神经学评估）的必要性。需要进一步研究以检查OSA治疗对癫痫结局的影响。
•阻塞性睡眠呼吸暂停（OSA）和癫痫是儿童中常见的神经系统疾病，有证据表明成人睡眠障碍与癫痫之间存在双向关系。•难治性癫痫儿童或服用多种抗癫痫药物（ASM）的儿童中OSA患病率显著更高。
•本研究表明，与匹配对照组相比，接受手术治疗的中度至重度OSA儿童的癫痫患病率增加了两倍。•OSA儿科患者的癫痫相关医疗保健利用率显著更高，包括住院、急诊就诊以及儿科神经科医生会诊。
