Two health conditions that probably seem to be completely unrelated, sleep apnea and epilepsy may be closer than you think. Both health conditions are fairly well known. Sleep apnea is most famous for the fact that sufferers stop breathing periodically during sleep, depriving them of oxygen as well as a good night’s rest. Epilepsy is a serious neurological condition in which seizures and other recurrent episodes of sensory disturbances are experienced.
What is Sleep Apnea?
A very serious condition which is typically caused by physical blockage of the breathing passages, sleep apnea is more common in men, and in people who are overweight. When people with obstructive sleep apnea (OSA) sleep, a barrier blocks their airways making it more difficult to breathe. This may be related to extra tissues which gravity pulls down over the airways, enlarged tongue, recessed jaw, deviated septum, swollen adenoids or tonsils (usually in children), or some other type of airway blockage.
When sleep apnea goes untreated, the condition that creates a serious lack of oxygen can cause a myriad of other health problems. High blood pressure, heart problems, enlarged heart, stroke, metabolic syndrome, gaining weight or inability to lose weight, atrial fibrillation, and quite a few other conditions have been connected as negative results linked to or caused by sleep apnea.
Central sleep apnea (CSA) is a condition with the same results in that the person stops breathing at intervals for periods of time during sleep. The difference is that central sleep apnea is caused by a malfunction in the brain that cannot seem to communicate to the respiratory system to tell it to breathe. This may be related to a brain injury, neurological problem, head or neck injury, or even opioid or other drug use that reduces brain function.
What is Epilepsy?
This neurological disorder is marked by seizures that come on suddenly and recur. These episodes may include convulsions, loss of consciousness, or sensory disturbance, and can all be associated with electrical activity in the brain that is not normal. About one in 20 people will have a single seizure at some time in their lives, and around 3 million adults and almost ½ million children in the United States have epilepsy. About 1/3 of people who are living with epilepsy are unable to control their seizures because there is no treatment that seems to work for them.
Epilepsy and Sleep Apnea Linked
The relationship between sleep apnea and epilepsy might not be as obvious as one might think, but actually the connection makes sense when carefully considered. For people with epilepsy, sleep apnea can be a problem because it has a tendency to aggravate epilepsy and exacerbate symptoms and seizures. People with sleep apnea have a drop in oxygen levels over many hours each night, eventually the brain may trigger seizures (even those that have in the past been controlled by medication.)
For people with epilepsy, any health disorder or condition that disrupts or fragments the sleep can change the brain and possibly facilitate an episode or seizure. Because sleep is purposed with activating the brain’s electrical charges, seizures can be timed according to sleep/wake cycles. And a lack of sleep is very often a trigger for epileptic seizures, so one of the most important factors in restoring health is to achieve healthy sleep every night.
Diagnosis of Sleep Apnea
People who have been diagnosed with epilepsy may be more likely to have sleep apnea than the average person. You should request a sleep study from their doctor if you suspect that you might be at risk for sleep apnea. Symptoms, signs, or risk factors to watch for related to sleep apnea may include:
- Loud snoring
- Waking up with headaches
- Waking up with a very sore, dry throat
- Noticeable pauses in breathing during sleep
- Waking up with a sensation of choking or gasping for air
- Obesity or weight gain
- Insomnia, inability to stay awake during activity
- Mood changes, relationship issues, decreased libido
- Regular use of alcohol
- Use of prescription medications such as opioids and narcotics
- Family history of sleep apnea
A sleep study will allow a medical professional to determine if your sleeping problem is sleep apnea, causing oxygen loss and possibly exacerbating the problems that you already have with epilepsy. Sleep studies are typically performed in a sleep clinic, in a room that looks similar to a hotel room (rather than a hospital room). The patient is connected to several non-invasive machines that will measure oxygen levels, brain wave activity, heart rate, pulse, snoring, body movements, and breathing rates.
Treatment for Epilepsy and Sleep Apnea
People who have been diagnosed with both epileptic seizures and sleep apnea may be able to mitigate some of their health problems by treating their sleep apnea. Although some people may need to continue on epilepsy medication for a time, certain people respond so well to their sleep apnea treatment that their doctors are able to lower the amount of anti-seizure medications they are taking. This is especially useful because some anti-seizure medications may actually create problems with sleep, so weaning off of them (when a doctor says it is safe) can be beneficial.
The most common treatment for sleep apnea that many people with epilepsy also find helpful is the use of a Continuous Positive Airway Pressure (CPAP) machine. This machine attaches to the face through tubes and a mask, pushing air into the airways during sleep to keep the breathing passages from closing, which can reduce or even eliminate the occurrence of sleep apnea breathing episodes.
Other effective treatment for sleep apnea may include weight loss (as people who carry excess weight are often at a higher risk) or positional therapy. Because people who sleep on their backs are more likely to experience sleep apnea breathing episodes, those who can change to sleeping on their sides or stomachs may be able to reduce or eliminate their sleep apnea. Dental appliances and surgery are other treatments that may work for people who have sleep apnea caused by a recessed jaw, deviated septum, or certain other problems.
Sleep apnea and epilepsy are both conditions that are serious and may even dangerous to the health or life-threatening. The good news is that there is hope for treatment and healing in many cases. As more information is revealed about how these two conditions are related, your health care team should seek to find solutions if you have them both. Restoring regular sleep through the treatment of sleep apnea may bring about a reduction in epileptic seizures, an increase in heart health, a reduction in obesity, and an overall restoration of your body’s health as well as your overall quality of life.