Epilepsy and OSA

[mars]

http://www.abc.net.au/news/2013-06-02/l ... ea/4728076

[avi123]

My oldest daughter, who is now close to 50, started with Febrile Convulsions at an age of 3 months. Later, in puberty it turned into epilepsy. There was no way that she could put on a CPAP machine even if she snored or had OSA (which was not the case). The myoclonic jerks would pull the CPAP machine over her body. At age of 20+ she had a surgical procedure to remove the offending tissues from her brain. It was successful and since then she is free of seizures (for 30 years).

[Julie]

The air hose would be pulled off the pipe... big deal, but even if it wasn't, I can't see that as being something to be worried about unless a very small child were involved.

[BlackSpinner]

To show you how stupid is the idea of putting an epileptic person on a CPAP, just imagine this person having a seizure while asleep with a CPAP, and the person starts to convulse with myoclonic body jerks. What would be the results if this person gets entangled with the air hose?

Are there more idiotic docters down there?

There are anti seizure medications you know, there have been for decades. I would think lack of O2 due to not using a cpap machine would be far more dangerous and seizure inducing then the occasional possible seizure. Besides people having seizures (even grand mal) do not roll around like tumble weeds - I dealt with more then a few when I was a teen and had a boyfriend who had epilepsy before there were effective seizure meds.

[nanwilson]

I have a daughter with epilepsy(grand mal) and osa...her epilepsy is well managed by her meds and her osa is well managed with cpap. You are barking up the wrong tree Avi....... both are well managed and very unlikely she will have a seizure in the middle of night and be choked by her hose. When a person has a seizure they don't ROLL around and get tangled in their hose, it would come away from the mask before anything would happen.

Welcome back Mars, happy to see you posting again.... you have too much knowledge to impart to folks here to be away from the forum for any length of time.

[jencat824]

My epilepsy nightmare happened after I was diagnosed & treated with OSA. I my case I don't think they are directly related, but I could see this scenario happening in many cases. I was on CPAP 4 yrs before what I call my 'seizure hell' started. It took 8 years to get my epilepsy under control. My seizures did not manifest as exactly 'grand mal', but rather that complete loss of consciousness. I would be standing & talking, just fine then just drop. My neurologist looked for & found some link to my seizures and sleep. This was after 9 sleep tests, 3 MSLT's & one 6 day nightmare seizure/sleep study where I was hooked up to more wires than a normal sleep test & in a hospital room with 2 glass windows. I'll never, ever go thru that awful test again!

My neurologist found the link in my case between sleep & my seizures, then finally found an effective drug, long after I gave up any hope. I have always been CPAP compliant & always will be. The link he found, however was not actually the OSA, but some connection to the alpha wave intrusion disorder that is a part of by sleep disordered breathing diagnosis.

I truly feel for all epileptics out there, both those with controlled & non controlled epilepsy.

Jen

[chunkyfrog]

I have three cousins with epilepsy; and another cousin had a child
with one the very, very severe cases --that required major brain surgery. (hemispherectomy)

[avi123]

I have three cousins with epilepsy; and another cousin had a child
with one the very, very severe cases --that required major brain surgery. (hemispherectomy)

Chunky, sorry to hear about that Hemispherectomy (which is a very rare surgical procedure where one cerebral hemisphere (half of the brain) is removed or disabled. This procedure is used to treat a variety of seizure disorders where the source of the epilepsy is localized to a broad area of a single hemisphere of the brain, among other disorders. It is solely reserved for extreme cases in which the seizures have not responded to medications and other less invasive surgeries.
Hemispherectomy is considered the most invasive surgical operation in use today, although not the most dangerous).

[BlackSpinner]

[
There was no way that she could have used a CPAP machine (if she needed to) because her myoclonic jerks during seizures would have pulled the CPAP machine plus the humidifier plus the night table, and you name it what, over her body. So Julia's above comment about NO problems with Epileptics using CPAPs is sheer ignorance. Another poster to go on my IGNORE list.

Right - because it is impossible to secure the cpap machine? Or get a quick release function on the hose that frees it from the machine with a quick jerk? I am sure such simple things could be done to allow an epileptic to use a cpap. So NO problems for an epileptic to use a machine. Pure sheer ignorance on your part.

[Greendirt]

The article says...

...patients with epilepsy can gain weight as a result of their medications, something that increases their risk of sleep-disordered breathing .... Doctors recruited 87 patients with epilepsy and monitored them in a sleep unit.
They found 25 per cent had significant sleep-disordered breathing that was severe enough to require treatment. In the general population, the prevalence of sleep-disordered breathing is 3 to 7 per cent

Ok... that's been reported before. Other studies have put the OSA rate among epileptics at more like 30%. But what is the link between E and OSA? Just weight from meds causing airway blockage? The article says nothing about the weight of the test subjects, so how is the link to weight supported? Just by a generalization that E sufferers are all fat because of their meds? Not true.

What about skinny epileptics with no obvious airway issues at all who are diagnosed with OSA and improve on CPAP? Mightn't there be brain activity associated with E that causes similar breathing issues as OSA and looks like OSA in a sleep study, but is in fact something related to E? I'd have thought brain caused apnoea would be reported as CSA, but maybe that depends on how the sleep study machines distinguish between OSA and CSA.

The article went on to give an example of an epileptic who got his OSA under control and his E improved. Being extremely tired will make any illness worse, including E, so that's good for him but not revealing as to the link between E and OSA. But the fact CPAP fixed the tiredness indicates there is something going on that pumping pressurized air down the airway overcomes. But that doesn't say anything about the cause of why, reportedly, E sufferers have much higher rates of OSA than the general population or what might be causing the symptoms of OSA in E sufferers.

So... what is the link between E and OSA?

[Greendirt]

I believe SDB prevalence among the general population is 25% or higher.

Yes. I'm not sure what rate of SDB is found in random control groups. So, say, if we did sleep studies on 87 random people off the street and saw what the results were. If it was 25% (or thereabouts), there would be no more reason to say there is a link to E than anything else. But I'd like to think a study provoking those comments from the researchers would be statistically valid to the extent they're not just reporting on the actual rate of SDB in the community but are actually reporting on a difference between the general population and one specific section of it.

This is one problem with reading a report on a study compared to reading the study itself. Poor articles can make good studies look silly.

[ChicagoGranny]

Poor articles can make good studies look silly.

+1