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Rutgers researchers have developed a tool to help neurologists screen for obstructive sleep apnea in people with epilepsy whose seizures can be amplified by sleep disorders.
The study appears in the review Clinical practice in neurology.
Although the detection and treatment of obstructive sleep apnea (OSA) may improve control of epileptic seizures in some patients with epilepsy, providers have not routinely assessed risk factors associated with these patients. Researchers have developed an electronic health record alert for neurologists to assess a patient's need for a sleep study.
This study may determine the need for treatment, which can help improve seizure control, reduce the number of antiepileptic drugs, and reduce the risk of sudden and unexpected death related to treatment. epilepsy.
OSA occurs when breathing is interrupted during sleep. The Epilepsy Foundation estimates that about 40% of people with epilepsy have a higher prevalence of OSA, which contributes to poor control of seizures.
"Sleep disorders are common among people with epilepsy and are underdiagnosed," said lead author Martha A. Mulvey, a nurse practitioner in the Department of Neuroscience at the University Hospital. . "Sleep and epilepsy have a complex reciprocal relationship: Seizures can often be triggered by low levels of oxygen that occur during OSA." Sleep deprivation and sleep interruption can therefore increase the frequency of seizures. "
The researchers developed an assessment to identify the OSAS, consisting of 12 recognized risk factors, integrated into the electronic health record. If a patient has at least two risk factors, he is referred to a sleep study. Risk factors include: body mass index greater than 30 kg / m2; snoring; choking or gasping in sleep; unexplained nocturnal awakenings; morning headaches; dry mouth, sore throat or chest tightness upon awakening; excessive urination at night; decreased memory and concentration; neck circumference greater than 17 inches; excessive daytime sleepiness; moving under the waist or behind the jaw; and an assessment of the distance between the base of the tongue and the roof of the mouth.
"It has been found that placing this mandatory alert for screening for OSA in the EHR significantly increases the detection of patients with risk epilepsy who should be referred for a sleep study", said Xue Ming, professor of neurology at Rutgers. New Jersey Medical School. "Such screening can lead to early detection and treatment, which will improve the quality of life of patients with epilepsy and OSA."
In cases reviewed before the alert was placed in the electronic health record, only 7% of patients with epilepsy were referred for sleep studies. Of those who were referred, 56% were diagnosed with sleep apnea. Of the 405 patients who were screened for OSA after the alert was placed in the electronic health record, 33% had at least two risk factors and were referred to a sleep study. . Of the 82 patients who completed a sleep study, 87% had at least one mild sleep apnea.
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Material provided by Rutgers University. Original written by Patti Verbanas. Note: Content can be changed for style and length.
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