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AAN 2025 | The prevalence and impact of sleep apnea in patients with epilepsy
Stefanie Dedeurwaerdere, PhD, UCB, Brussels, Belgium, comments on the growing body of evidence linking sleep apnea and epilepsy, noting that while initially considered a rare comorbidity, recent studies have shown a significant prevalence of sleep apnea in patients with epilepsy. Dr Dedeurwaerdere highlights the impact of sleep apnea on patients’ lives, including impaired cognitive functioning and increased seizure severity, and notes that positive airway pressure treatment can be beneficial. This interview took place at the 77th American Academy of Neurology (AAN) Annual Meeting in San Diego, CA.
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Transcript
In 1981 there was like a first case study talking about an epilepsy patient in their 20s that was having sleep apnea and upon the treatment of the sleep apnea the doctor saw that the refractory generalized seizures that the patient was facing were improving. And they made a small note at the end of the paper that this is probably a rare situation where you have sleep apnea and epilepsy at the same time, but that it was important to bring it to the attention of physicians given the impact on the positive outcome of the seizures after the sleep apnea treatment...
In 1981 there was like a first case study talking about an epilepsy patient in their 20s that was having sleep apnea and upon the treatment of the sleep apnea the doctor saw that the refractory generalized seizures that the patient was facing were improving. And they made a small note at the end of the paper that this is probably a rare situation where you have sleep apnea and epilepsy at the same time, but that it was important to bring it to the attention of physicians given the impact on the positive outcome of the seizures after the sleep apnea treatment. And now many more publications have been published, probably thousands of papers describing the link between epilepsy and sleep apnea and so it’s clear that this is more common than initially thought. Of course it depends on if you’re doing a retrospective study, usually the numbers are a little bit higher. There’s only a couple of prospective studies and they have shown that in children probably around 10% of children may have sleep apnea with epilepsy and in the adult population around 20%. This is actually very much in line with our own research. Being able to use large-scale database, we were able to show that indeed in the children we see about 11% prevalence of sleep apnea in uncontrolled epilepsy and in adults around 17%. So very much in line with those smaller scale prospective studies. To your question, what is the impact of this on patients’ lives? There’s of course the elements that are typical for having obstructive sleep apnea in anyone, like excess daytime sleepiness. It will add to your cognitive functioning, which will be impaired. But in epilepsy specifically, there’s additional interaction with sleep apnea which causes seizures to be worse, even refractory to anti-seizure medicine. And this is where also literature has shown that positive airway pressure treatment can actually help.
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Disclosures
Employee at UCB.
