• Raffaele Manni, Michele Terzaghi, Carla Arbasino, Ivana Sartori, Carlo Andrea Galimberti, and Amelia Tartara.
• Unit of Sleep Medicine and Epilepsy, C Mondino Institute of Neurology, Pavia, Italy. raffaele.manni@mondino.it
• Epilepsia. 2003 Jun 1;44(6):836-40.

PurposeThe aim of this study was to evaluate the rate and features of obstructive sleep apnea (OSA) in adult epilepsy patients.MethodsTwo hundred eighty-three adult epilepsy patients (137 men; mean age, 33 years; range, 18-70 years) were prospectively screened for OSA by means of a structured interview. Those in whom OSA was clinically suspected were monitored for a full night by using a portable device (Polymesam), and OSA was diagnosed when they had an Apnea/Hypopnea Index greater than five.ResultsCoexistence of OSA with epilepsy was found in 10.2% (15.4% of the male and 5.4% of the female) epilepsy patients investigated. The OSA was mild in 66.6%, moderate in 22.2%, and severe in 11.1% of the cases. The "epilepsy + OSA" patients were older, heavier, more frequently male, and sleepier (p < 0.05) than those with "epilepsy only." Furthermore, they experienced their first seizure at an older age (p < 0.05).ConclusionsSystematic investigation reveals that OSA is frequent in epilepsy patients. The major risk factors for OSA in our epilepsy patients were the same as those typically found in the general population. Of the epilepsy-related factors, older age at onset of seizures appears to be significantly related to comorbidity with OSA (p < 0.05). The presence in epilepsy patients of these features should alert the clinician to the possibility of an underlying OSA.

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