1037 Comorbid Insomnia and Sleep Apnea in Epilepsy Patients

Abstract

Introduction

Obstructive Sleep Apnea (OSA) is very common in patients with epilepsy disorders, especially in refractory cases. Both epilepsy patients and OSA patients can have complaints of insomnia as a prevalent symptom. Additionally, about 30% of patients with chronic insomnia have OSA, and nearly 40% of people with OSA also have insomnia symptoms. This is known as Comorbid Insomnia and Sleep Apnea (COMISA). The objective of this study was to describe COMISA in patients with epilepsy.

Methods

We performed a retrospective observational study of adult patients with epilepsy with a concomitant diagnosis of OSA who presented for clinical visits between 10/01/2022 and 09/30/2023 at a sleep center. 57 patients were identified with either seizures or an epilepsy disorder. Among those patients, 9 patients were found to have concurrent OSA and met study criteria. Electronic medical records were reviewed to identify those with insomnia complaints.

Results

Preliminary results of the study are presented. Most patients were female (n=6, 66.7%%), with a mean age of 36.33 + 0.7 years. On review of the patients’ polysomnography, the mean apnea hypopnea index (AHI) was 15.63 + 10.74/hour, total sleep time (TST) was 342.05 + 104 minutes, and sleep efficiency was 64.92 + 0.21%. Four patients (44.4%) had COMISA. Among the patients with COMISA, the mean AHI was 16.65 + 10.74%. The mean TST (239 + 104.65 minutes) and mean sleep efficiency (45.78 + 21.6%) were significantly reduced and mean sleep latency was high (37.65 + 0.42 minutes).

Conclusion

Based on our retrospective screening, the prevalence of insomnia in patients with OSA and seizure disorders is quite high. Further large retrospective and longitudinal studies are required to identify the patients at risk of COMISA in epilepsy with the help of clinical and polysomnographic evaluation.

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