COMMENTARY

How Frequent Are Sleep Disorders in Drug-Resistant Epilepsy?

Andrew N. Wilner, MD

Disclosures

December 14, 2015

Sleep Questionnaires in Drug-Resistant Epilepsy

Sleep disorders are more common in people with epilepsy than healthy controls, and may contribute to increased seizure frequency.[1] Nocturnal seizures may also interfere with sleep, resulting in a potentially vicious cycle of poor sleep and poor seizure control. Treatment of obstructive sleep apnea may improve seizure control.[2]

To determine the likelihood of sleep disorders in patients with drug-resistant epilepsy, the authors of a recent study administered three sleep questionnaires to 101 patients with temporal lobe epilepsy and 88 patients extratemporal lobe epilepsy who were undergoing EEG/video monitoring.[1] The patients completed the Medical Outcome Study Sleep Scale (MOS-SS), Epworth Sleepiness Scale (ESS), and Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ).*

Patients with temporal lobe epilepsy scored higher on the ESS (11) than those with extratemporal lobe epilepsy (8), but this difference was not statistically significant. Scores on the MOS-SS were also similar. However, symptoms of obstructive sleep apnea were higher in those with temporal lobe epilepsy than with extratemporal lobe epilepsy, according to results from the 12-item SA-SDQ questionnaire (p=0.04). The SA-SDQ has previously been validated for the screening of obstructive sleep apnea in patients with epilepsy.[3] Based on prior observations, obstructive sleep apnea would be expected in approximately one-third of patients with drug-resistant epilepsy.[4]

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