Data from: Sleep-disordered breathing among patients admitted for inpatient video-EEG monitoring

Objective: Examine the frequency and risk factors of sleep-disordered
breathing in individuals with epilepsy and psychogenic non-epileptic
events (PNES). Methods: We conducted a cross-sectional study of
consecutive patients admitted for inpatient video-EEG monitoring at The
Royal Melbourne Hospital, Australia between December 1, 2011 and July 31,
2017. Participants underwent routine clinical investigations during their
monitoring period including polysomnography, neurocognitive testing, and
screening instruments of daytime somnolence, sleep quality, and quality of
life. Results: Our study population consisted of 370 participants who
received a diagnosis of epilepsy (n=255), PNES (n=93), or both disorders
(n=22). Moderate-to-severe sleep-disordered breathing (defined by an
apnea-hypopnea index ≥15) was observed in 26.5% (98/370) individuals, and
did not differ across subgroups: epilepsy 26.3% (67/255), PNES 29.0%
(27/93) or both disorders 18.2% (4/22; p=0.610). Following adjustment for
confounders, pathological daytime sleepiness predicted moderate-to-severe
sleep-disordered breathing in epilepsy (OR 10.35, 95% CI: 2.09-51.39;
p=0.004). In multivariable analysis, independent predictors for
moderate-to-severe sleep-disordered breathing in epilepsy were older age
(OR 1.07, 95% CI: 1.04-1.10; p<0.001) and higher body-mass index
(OR 1.06, 95% CI: 1.01-1.11; p=0.029), and in PNES older age (OR 1.10, 95%
CI: 1.03-1.16; p=0.002). Conclusion: Polysomnography during inpatient
video-EEG monitoring identified a substantial number of patients with
undiagnosed sleep-disordered breathing. This was notable in the subgroup
with PNES, who were often female and obese. Identification of risk factors
may improve management of sleep-disordered breathing in these populations.
The association with pathological daytime sleepiness suggests that
sleep-disordered breathing may be an important contributor to these common
and disabling symptoms in patients with epilepsy.