Epilepsy Talk

Epilepsy And Sleep Apnea — A Dangerous Duo | June 10, 2013

Sleep apnea is one of the most common and important sleep disorders, because of the possible serious consequences.

Basically (as you probably already know), sleep apnea is characterized by abnormal pauses in breathing or instances of abnormally low breathing during sleep.

Each pause in breathing, called an apnea, can last from at least ten seconds to minutes, and may occur 5 to 30 times or more an hour, causing partial airway obstruction.

As sleep deepens, your airway becomes blocked.

Your brain recognizes the resulting lack of oxygen, and you wake up — usually with a loud snore and then begin to breathe again.

Often you don’t remember waking up — although I’m sure your partner remembers — but this cycle is repeated all night long and there’s really no high quality sleep.

That’s because synchronized nonrapid eye movement (NREM) sleep tends to facilitate seizures.

While desynchronized rapid eye movement (REM) sleep discourages seizure occurrence.

The most common complaints of sleep apnea are excessive daytime sleepiness and frequent awakenings.

There can also be symptoms like grinding your teeth, a dry mouth, morning headaches, erectile dysfunction, memory deficits, and snoring.

But most importantly, this sleep deprivation provokes seizures and epileptiform discharges in some people with epilepsy.

30% thirty per cent of those with medically refractory epilepsy are likely to have seizures caused by sleep apnea.

Not surprisingly, a Norwegian study of 794 patients with epilepsy concluded that the most common triggers for seizures were emotional stress, sleep deprivation and tiredness. For people with epilepsy, healthy sleep is essential for effective control of seizures.

And for those with epilepsy, sleep problems are a double-edged sword.

Epilepsy disturbs sleep and sleep deprivation aggravates epilepsy.

It’s an endless cycle.

But there’s more to sleep apnea than what meets the eye. (No pun intended.)

There are actually three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea (a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively.

In CSA, your breathing is interrupted by a lack of respiratory effort.

In OSA, your breathing is interrupted by a physical block to airflow — despite respiratory effort — and snoring is common.

During central apneas, your central respiratory drive is absent, and your brain does not respond to changing blood levels of the respiratory gases.

No breath is taken, despite the normal signals to inhale.

The immediate effects of central sleep apnea on your body depends on how long the failure to breathe endures.

Drops in blood oxygen can trigger seizures, even in the absence of epilepsy.

And if you do have epilepsy, the inadequate oxygen caused by apnea may trigger seizures that had previously been well controlled by medications.

Conversely, some antiepileptic drugs (AEDs) adversely affect the continuity of sleep.

“Any disorder that fragments, or disrupts, sleep can change the overall excitability, and irritability, of the brain,” says Beth Malow, M.D., M.S., an assistant professor of neurology at the U-M Health System.

“In a person with epilepsy, the sleep disruption may facilitate a seizure.”

If sleep apnea is suspected, or your sleep is just so fragmented that you’re having seizures and difficulties during the day, a sleep study is highly recommended.

Sleep studies (Polysomnography) with expanded EEG aids can indicate the difference between seizures and parasomnias — a different kind sleep disorder — and diagnosis if the condition is truly sleep apnea, which can exacerbate seizures.

Treating sleep apnea may lead to improved seizure control. Which makes this diagnosis especially important in terms of sleep quality and treating epilepsy.

Treatment options include continuous positive airway pressure (CPAP), oral appliances for repositioning of the airway, surgery (reducing the tissue in the throat and improving airflow), and conservative treatments like sleep positioning and weight loss.

A randomized, controlled trial showed that approximately one third of people who received continuous positive airway pressure (CPAP) treatment had a 50% or greater reduction in seizure frequency, compared with only 15% of subjects who improved on a CPAP placebo.

“We did observe a significant trend toward improvement in seizure frequency among patients who received CPAP — a result that rivals that of an antiepileptic drug,” principal investigator Dr. Beth Ann Malow said.

The CPAP machine generates the required air pressure to keep your airways open during sleep.

Involved is a plastic facial mask, which is connected by a flexible tube to a small bedside CPAP machine.

Advanced models may warm or humidify the air and monitor your breathing to ensure proper treatment.

Although CPAP therapy is extremely effective in reducing apneas and less expensive than other treatments, some people find it extremely uncomfortable.

In fact, lots of people refuse to continue the therapy or fail to use their CPAP machines on a nightly basis, especially in the long term.

But more comfortable CPAP face masks are available.

CPAP masks come in different shapes, sizes and materials to ensure effective treatment for obstructive sleep apnea.

It’s more of matter of pursuing the mask that best fits you.

With that, you’ll be on your way to a better night’s sleep and hopefully, seizure relief. 

 

To subscribe to Epilepsytalk.com and get the latest articles, go to the bottom box of the right column, enter your email address and click on “Follow”

Other articles of interest

Sleep Apnea Linked To Hearing Loss In New Study  http://www.medpagetoday.com/Pulmonology/SleepDisorders/43710  

Nerve Pacing Device Eases Sleep Apnea  http://www.medpagetoday.com/Pulmonology/SleepDisorders/43710

Seizures and Sleep Disorders  https://epilepsytalk.com/2012/10/16/seizures-and-sleep-disorders/

Nocturnal Seizures — A Living Nightmare https://epilepsytalk.com/2013/03/18/nocturnal-seizures-a-living-nightmare-2/

Resources:

http://www.sleepfoundation.org/article/sleep-related-problems/epilepsy-and-sleep

http://www.sciencedaily.com/releases/2000/10/001012074517.htm

http://www.medscape.com/viewarticle/548724

http://www.medscape.com/viewarticle/713994

http://sleepdisorders.about.com/od/causesofsleepdisorder1/a/Sleep_Seizures.htm

http://my.epilepsy.com/epilepsy/sleep_types_disorder

http://en.wikipedia.org/wiki/Sleep_apnea#Medications


20 Comments »

  1. I know what you mean. Cause I have it myself. I know there are nights where I don’t want to wear it cause of the humidity. If I don’t wear it I wake up the next morning feeling weak and tired and short of breath because I sleep with my mouth open all night. Having this machine has helped me out the last 4yrs. I heard a lot of others don’t like wearing them either.

    Like

    Comment by Corina — June 10, 2013 @ 4:33 PM

  2. No, it’s kinda cumbersome and doesn’t make one feel like a beauty pageant contestant 🙂

    But it works well and helps you breathe, which in turn, helps get you through the day.

    A major advantage!!!

    Like

    Comment by Phylis Feiner Johnson — June 10, 2013 @ 7:21 PM

  3. Very sad, in this article they assumed that everyone has a partner….

    Like

    Comment by Darlene — July 15, 2013 @ 12:46 AM

  4. I’m sorry.

    Like

    Comment by Phylis Feiner Johnson — July 15, 2013 @ 8:40 AM

  5. thank you for the info…. Ive had my cpap machine for just over a month and its helped for sure… Ive noticed more energy and the seizures have reduced.. still seeing a neurologist soon… I admit I hate wearing the mask some nights.. but then i think of why Im wearing it… I guess I had 26 apneas per hour… i stopped breathing … all night.. scary stuff… For me my anxiety has also come down as i don’t have the lack of sleep happening.. which is turn reduces the seizures.. Previously i had them every 10 days roughly, the 1st month was 30 days seizure free then 15.Today is about 14 days… sooo im hoping it doesnt happen…. but i know its kinda part of me. although not really diagnosed really. Wondering if the sleep apnea is the cause completely and if the seizures will just go away.. They stopped previously.. I know wishful thinking.. 🙂

    Like

    Comment by laura — January 28, 2015 @ 4:37 PM

    • Maybe you could nail it down with an official sleep study?

      At any rate, it sounds like you’re getting better.

      But just in case you’re interested, here’s an article about: Sleep Apnea — Three Revolutionary New Types of CPAP

      https://epilepsytalk.com/2014/11/08/for-sleep-apnea-three-revolutionary-new-types-of-cpap/

      Like

      Comment by Phylis Feiner Johnson — January 28, 2015 @ 5:12 PM

    • I’ve had sleep apnea for the last 7 years. I might of had it before that and didn’t know I did until I was having problems sleeping and lots of seizures were occurring back then. I do sleep better than I did years ago cause being over weight back then too could of trigger my sleep apnea in me . Everyone is different cause I’ve lost a lot of weight the last 4 years.

      Like

      Comment by Corina Perry — January 28, 2015 @ 5:25 PM

  6. Good for, you. On both fronts.

    (My husband says that when I sleep on my back, I snore like a saw.)

    Actually, if you are sleeping on your back, try changing your sleeping position and sleep on your side instead.

    It’s the best position for relaxing, and allows all your internal organs to rest properly.

    This may be due to the effects of gravity, which cause your throat to narrow when you lie on your back and allows more oxygen in when you sleep on your side.

    Special pillows can also help maintain this position.

    12 Sleep Tricks https://epilepsytalk.com/2014/04/27/12-sleep-tricks/

    Like

    Comment by Phylis Feiner Johnson — January 28, 2015 @ 5:49 PM

  7. Is there anything one can do to aliviate snoring? People tell me I do and it’s embarasing. I think it causes me to have sore throats in the morning too.

    Like

    Comment by Vance — January 30, 2015 @ 1:10 PM

    • My husband says I snore like a saw when I sleep on my back.

      The best solution is to sleep on either side.

      The bonus is that it allows the oxygen to circulate unobstructed.

      Like

      Comment by Phylis Feiner Johnson — January 30, 2015 @ 2:12 PM

  8. […] to find an article that says just how many people with seizures may have apnea, but this one https://epilepsytalk.com/2013/06/10/e…dangerous-duo/ says 30% of those with medically refractory seizures are likely to have sleep apnea (the author of […]

    Like

    Pingback by For Anyone with Nocturnal Seizures - Epilepsy Forum — May 16, 2015 @ 11:46 AM

  9. I never achieved seizure control until after I was diagnosed with sleep apnea and started using a CPAP machine.

    Like

    Comment by David Naess — November 24, 2015 @ 11:55 AM

    • I had seizures already but years later down the road I found out I had sleep apnea. Part it was I was over weight then and some meds due cause you to gain weight. Now these days I’m doing a whole lot better then was over 8 years ago. I still use a CPAP machine even though I’ve lost a lot of weight. The meds I’m on now control and I have a VNS in me that has helped out a lot.

      Like

      Comment by Corina — November 24, 2015 @ 4:55 PM

  10. It can sometimes be pretty tricky.

    Glad you caught the culprit.

    So are you, I’m sure! 🙂

    Like

    Comment by Phylis Feiner Johnson — November 24, 2015 @ 3:03 PM

  11. Hello, my husband suffering from sleep apnea from 2005. One day he was so tired and resting he just fall asleep without using CPAP, 30 minutes later he had 2 seizures resulting one fractured shoulder in the left and another broken shoulder in the right. Doctor says maybe this happen due to lack of oxygen in the brain. He is recovering now he has some memory issues. Sometimes he is fine and sometimes he has low cognitive and confusion.

    Like

    Comment by Yascad — February 19, 2016 @ 10:11 AM

  12. The cognitive issues will probably restore themselves.

    You might consider a sleep study,(Polysomnography), which with expanded EEG aids can indicate the difference between seizures and parasomnias — a different kind sleep disorder — and diagnosis if the condition is truly sleep apnea, or something else.

    Like

    Comment by Phylis Feiner Johnson — February 19, 2016 @ 10:34 AM

  13. I don,t have sleep apnea.

    Like

    Comment by michele metzger — May 13, 2016 @ 11:25 AM

  14. EXCELLENT!

    Like

    Comment by Phylis Feiner Johnson — May 13, 2016 @ 2:12 PM


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

    View Full Profile →

    Enter your email address to follow this blog and receive notifications of new posts by email.

    Join 2,295 other followers

    Follow Epilepsy Talk on WordPress.com
%d bloggers like this: