Does PAP Therapy Improve Seizure Control in Epilepsy Patients With OSA?

Obstructive sleep apnea is highly prevalent in patients with epilepsy
Obstructive sleep apnea is highly prevalent in patients with epilepsy

People with epilepsy and obstructive sleep apnea (OSA) have better seizure outcomes at 1 year after treatment with positive airway pressure (PAP) compared with patients with untreated OSA and no OSA, according to data presented at the 2017 American Epilepsy Society Annual Meeting, December 1-5, 2017 in Washington, DC.

Previous studies have shown improved short-term seizure control in patients who receive PAP therapy. The researchers in the current study sought to examine long-term outcomes in this population.

The study included 197 patients with epilepsy (mean age, 43.9 years; 54% seizure-free at baseline) who were followed for a mean of 5.4 years. Of the participants, 122 (62%) had OSA; 73 (60%) were on PAP therapy and 49 (40%) were untreated. Participants with no OSA were younger, more likely to be female, and had lower body mass index than those with treated or untreated OSA. 

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Overall, more patients with PAP-treated OSA were responders (63%, P =.001), described as a ≥50% reduction in seizures from baseline, compared with patients with untreated (14%) or no (44%) OSA. Overall success – described as being seizure-free at baseline and remaining seizure-free for 1 year, or having seizures at baseline and experiencing ≥50% seizure-reduction over 1 year – was achieved by 85% of patients treated with PAP therapy compared with 55% and 65% of patients with untreated or no OSA, respectively. After adjusting for baseline seizure freedom and standard AED dosing, OSA treated with PAP therapy remained more successful than untreated or no OSA. The researchers noted that no significant differences were present at 3 or 5 year follow-up.

The findings expand “existing literature supporting the impact of sleep therapies on seizure control,” the researchers concluded.

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Reference

Somboon T, Andrew N, Bena J, Wang L, Foldvary-Schaefer N. Long-term seizure control in epileptic patients with obstructive sleep apnea using positive airway pressure therapy. Presented at: 2017 American Epilepsy Society Annual Meeting. December 1-5, 2017; Washington, DC. Abstract 1.201.