Wednesday, October 7, 2009

Sleep apnea and seizures

Apparently there may be some connection between sleep apnea and seizures. Although there isn’t any solid evidence that sleep apnea causes seizures or convulsions, but some seem to think correcting sleep apnea will help with the seizures.

What is a grand mal seizure?

A grand mal seizure is where you lose consciousness and you have violent muscle contractions. This type of seizure is common with epilepsy patients. (Read more about it at but you can have a grand mal seizure and not be a epileptic. A neurologist is the doctor that you would see if you had seizures because it’s a disorder of the brain. Medications are used to keep seizures under control.

Sleep deprivation is considered one of the risk factors of grand mal seizure. So it would make sense that sleep apnea folks would be at risk for seizures. Studies have also found that people with epilepsy also have a higher percentage of sleep apnea than the regular population. The lack of oxygen to the brain can trigger the seizures. In some studies the use of Cpap machine by epileptic patients who have sleep apnea has help lessen their seizures.

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  1. If you look at all the studies out there on the link between sleep apnea and seizures, it's puzzling why not all seizure patients are at least screened for obstructive sleep apnea. Considering that a very high percentage of the population has sleep-breathing disorders, simply even asking about snoring and sleep-breathing issues may be better than nothing. If there were a standardized, low-cost home screening device, it would be even better.

    Studies have shown that repeated obstructions and hypoxia lowers the seizure threshold, making someone susceptible to seizures more symptomatic. If you already have a "lesion" from trauma, a growth or after surgery, then lowering your seizure threshold can bring on symptoms.

    As long as the medical community continues to compartmentalize all the different medical conditions into various specialties, there won't be any major progress. With the human body, everything's connected.

    By the way, If you're interested, I'll give you my theory about sleep apnea and Meniere's disease.

  2. Thanks Dr. Parks for all the comments on the posts they have been very informative. I would like to hear your theory on meniere's disease and sleep apnea.

  3. I can relate to your confusion. I first started having grand mal seizures in my sleep when I was 32, their frequency increased to approx. once a month (with a max of 2 in one week). My wife noticed that I gasped for air in my sleep, and sometimes there was a noticeable gap in my breathing in my sleep. Despite the fact that all of my seizures were in my sleep and my wife noticed breathing problems in my sleep, I saw 4 neurologists in 2 years and all of them dismissed apnea as an issue (it took me two years, two years of hell on epilepsy medication that exacerbates apnea, to find a neurologist that would actually give me a sleep study as the others thought that I "was not fat enough" for apnea). Each of them claimed that there was no proof of a relationship. Unfortunately, they used the textbook definition of proof (which is not relevant in neurology - i.e. most of the conditions in neurology are not amenable to randomized-controlled experiments). They all ignored the fact that since the 1980s there has been substantial evidence that there is a pathogenic link (unfortunately since the late 90s work in this area died off, it is now a fashionable issue once again, mainly thanks to Beth Malow at Vanderbilt). If any neurologist uses the word "proof" in their diagnoses, get as far away from them as possible. Stick to the ones who refer to "evidence."

    There are a lot of papers out there that study the relationship between seizures and apnea, here are a few of the key results:

    "Epilepsy and sleep apnea syndrome," Neurology, 1994, vol. 44, no11, pp. 2060-2064, "Obstructive sleep apnea is common in medically refractory epilepsy patients," Neurology, 2000, vol. 55, no7, pp. 1002-1007 (where one third of patients with epilepsy were found to have apnea, 50% for males). In 2006 a researcher went as far as to say: "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 Beth Ann Malow, MD, from Vanderbilt University. “Three of the patients became seizure free and a fourth patient had a greater than 95% reduction in seizure frequency following only the initiation of therapy for the sleep apnoea.”Vaughn et al., 1996 .

  4. Thanks for wonderful comment! I will put it in my next sleep apnea post!
    thanks again
    and stay in touch

  5. I would love to know how the previous writer come out of his situation. I am having very similar circumstances. My seizures come on during my sleep. Usually, I would wake up and draw in a big breath (as though I have been holding my breath) and the seizure would start. My wife also said that I have gaps in my breathing during sleep as well.