Abstracts

RATIONALE: Sleep fragmentation and deprivation, and hypoxia associated to RDS may contribute to the occurrence of seizures. On the other hand, antiepileptic drugs may worsen RDS by reducing the muscle tone of the upper airways and increasing the arousal threshold. A few studies indicate that treatment of the RDS can reduce both frequency and intensity of seizures. These studies, however, are anecdotical or regard a small number of patients. Furthermore, the duration of the follow-up period is seldom mentioned, and non-compliance to the ventilatory treatment is overlooked. METHODS: In order to further understand the relationship between RDS and epilepsy, we studied a group of 8 selected patients affected by symptomatic or cryptogenetic partial epilepsy associated to RDS (OSAS or COBP and snoring). Each patient underwent two nocturnal polysomnographic (PSG) studies before and after ventilatory therapy with cPAP (in 6 patients with OSAS) or O2 (in 2 patients with BPCO and snoring). Spiking rates were quantified during the first sleep cycle in both PSG studies, for the entire cycle and for each separate sleep phase. RESULTS: In all patients, the improvement of the RDS after ventilatory treatment determined a reduction of spiking rates both in the entire cycle and, especially, in relationship to arousals and awakenings. This reduction was particularly marked in patients with higher spiking rates in baseline conditions. CONCLUSIONS: Our data suggest that RDS play a role in increasing the epileptiform activity, especially by determining a fragmentation of sleep. Therefore, the treatment of RDS in epileptic patients should not be neglected.