@article{2c83154379f943dc9f1686d348d88593,
title = "Obstructive sleep apnea in refractory epilepsy: A pilot study investigating frequency, clinical features, and association with risk of sudden unexpected death in epilepsy",
abstract = "Objective: We aimed to determine the frequency of probable obstructive sleep apnea (pOSA) in refractory epilepsy monitoring unit inpatients and clinical features associated with pOSA, including risk for sudden unexpected death in epilepsy (SUDEP). Methods: We prospectively recruited 49 consecutive adult patients admitted to the Mayo Clinic Epilepsy Monitoring Unit with focal, generalized, or unclassified epilepsy syndromes. pOSA was identified using oximetric oxyhemoglobin desaturation index (ODI) and the Sleep Apnea–Sleep Disorders Questionnaire (SA-SDQ) and STOP-BAG screening tools. Revised SUDEP Risk Inventory (rSUDEP-7) scores were calculated, and epilepsy patients with and without pOSA were compared with Wilcoxon signed-rank tests. Correlation and regression analyses were utilized to determine relationships between pOSA and rSUDEP-7 scores. Results: Thirty-five percent of patients had pOSA, with a mean ODI of 11.3 ± 5.1/h (range = 5.1-22.8). Patients with pOSA were older and heavier, and more frequently had a focal epilepsy syndrome and longer epilepsy duration, with higher SA-SDQ and STOP-BAG scores (all P < 0.05). Median rSUDEP-7 score was 3 ± 1.4 (range = 0-6). Higher rSUDEP-7 scores were positively correlated with higher ODI (P = 0.036). rSUDEP-7 score ≥ 5 was associated with pOSA by ODI, SA-SDQ, and STOP-BAG questionnaire criteria (P < 0.05). Significance: Our pilot study identified a high frequency of pOSA in refractory epilepsy monitoring patients, finding that pOSA patients were older and heavier, with higher screening symptoms for sleep apnea and more frequent focal seizures with a longer epilepsy duration. We also found a possible association between OSA and SUDEP risk. Identification and treatment of OSA in patients with epilepsy could conceivably provide a novel approach toward preventing the risk of SUDEP. Future studies with polysomnography are needed to confirm predictive features for OSA in epilepsy populations, and to determine whether OSA is associated with SUDEP risk.",
keywords = "SUDEP-7, epilepsy, obstructive sleep apnea, revised SUDEP-7, sudden unexpected death in epilepsy",
author = "McCarter, {Allison R.} and Timm, {Paul C.} and Shepard, {Paul W.} and Sandness, {David J.} and Thao Luu and McCarter, {Stuart J.} and Lucas Dueffert and Max Dresow and Feemster, {John C.} and Cascino, {Gregory D.} and So, {Elson L.} and Worrell, {Gregory A.} and Britton, {Jeffrey R.} and Akil Sherif and Keerthi Jaliparthy and Chahal, {Anwar A.} and Somers, {Virend K.} and {St. Louis}, {Erik K.}",
note = "Funding Information: The project described was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number 1 UL1 RR024150‐01. V.K.S. and E.K.S.L. receive support from NIH HL‐65176. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. We are additionally grateful for secretarial support in manuscript preparation and submission from Ms. Lea Dacy, Mayo Clinic Department of Neurology. Funding Information: Funding information Supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number 1 UL1 RR024150-01. A.C. and V.K.S. are supported by NIH HL65176 and NIH HL134885. A.C. is supported by the American Heart Association (award number 17POST33400211). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The project described was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number 1 UL1 RR024150-01. V.K.S. and E.K.S.L. receive support from NIH HL-65176. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. We are additionally grateful for secretarial support in manuscript preparation and submission from Ms. Lea Dacy, Mayo Clinic Department of Neurology. Funding Information: Supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number 1 UL1 RR024150‐01. A.C. and V.K.S. are supported by NIH HL65176 and NIH HL134885. A.C. is supported by the American Heart Association (award number 17POST33400211). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Publisher Copyright: Wiley Periodicals, Inc. {\textcopyright} 2018 International League Against Epilepsy Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
year = "2018",
month = oct,
doi = "10.1111/epi.14548",
language = "English (US)",
volume = "59",
pages = "1973--1981",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "10",
}