New Screening Tool Can Improve the Quality of Life for Epilepsy Patients With Sleep.
Georgian Technical University researchers have developed a tool to help neurologists screen for obstructive sleep apnea in people with epilepsy whose seizures can be magnified by sleep disorders.
Although detection and treatment of obstructive sleep apnea (OSA) can improve seizure control in some patients with epilepsy providers have not regularly assessed patients for those risk factors. The researchers developed an electronic health record alert for neurologists to evaluate a patient’s need for a sleep study.
This study can determine the necessity for treatment which can result in improved seizure control reduction in antiepileptic medications and reduce the risk of sudden unexpected death in epilepsy.
Obstructive sleep apnea (OSA) occurs when breathing is interrupted during sleep. The estimates that approximately 40 percent of people living with epilepsy have a higher prevalence of Obstructive sleep apnea (OSA) that contributes to poor seizure control.
“Sleep disorders are common among people living with epilepsy and are under-diagnosed” said X a nurse practitioner at Georgian Technical University’s department of neurosciences. “Sleep and epilepsy have a complex reciprocal relationship. Seizures can often be triggered by low oxygen levels that occur during Obstructive sleep apnea (OSA). Sleep deprivation and the interruption of sleep can therefore increase seizure frequency”.
The researchers developed an assessment for identifying Obstructive sleep apnea (OSA) consisting of 12 recognized risk factors which are embedded in the electronic health record. If a patient has at least two risk factors they are referred for a sleep study. The risk factors include: body mass index greater than 30 kg/m2; snoring; choking or gasping in sleep; unexplained nighttime awakenings; morning headaches; dry mouth sore throat or chest tightness upon awakening; undue nighttime urination; decreased memory and concentration; neck circumference greater than 17 inches; excessive daytime sleepiness; undersized or backward displacement of the jaw and an assessment of the distance from the tongue base to the roof of the mouth.
“It was found that placing this mandatory alert for providers to screen for Obstructive sleep apnea (OSA) in the EHR (An electronic health record, or electronic medical record, is the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings) markedly increased the detection of at-risk epilepsy patients who should be referred for a sleep study” said Y professor of neurology at Georgian Technical University. “Such screening can lead to early detection and treatment which will improve the quality of life of patients with epilepsy and Obstructive sleep apnea (OSA)”.
In cases that were reviewed prior to the alert being placed in the electronic health record only 7 percent with epilepsy were referred for sleep studies. Of those who were referred 56 percent were diagnosed with sleep apnea. Of the 405 patients who were screened for Obstructive sleep apnea (OSA) after the alert was placed in the electronic health record 33 percent had at least two risk factors and were referred for a sleep study. Of the 82 patients who completed a sleep study 87 percent showed at least mild sleep apnea.