Grant: CIHR Fellowship

Epilepsy is one of the most common neurological disorders, affecting more than 3 million people in North America. Although antiepileptic drugs help control seizures in most patients, many individuals have pharmacoresistant epilepsy. These individuals have poorer quality of life, and more than twentyfold greater risk of death when compared with the rest of population, and it often occur during sleep. Obstructive sleep apnea (OSA) is among the major factors contributing to seizures in epilepsy patients. By causing nocturnal episodes of intermittent hypoxemia (abnormally low blood oxygen) and sleep fragmentation, OSA may exacerbate seizures occurrence. Sleep apnea is also a well-known risk factor for cognitive deficits. Whether OSA in epilepsy patients is associated with worse cognitive functioning is poorly understood. Though, it is well established that consistent and accurate treatment of OSA with continuous positive airway pressure (CPAP) therapy may reverse some of the cognitive deficits. However, whether CPAP therapy might improve cognitive functions in patients with epilepsy and sleep apnea has never been studied to date. The goal of the present study is to determine the cognitive burden of sleep apnea in patients with epilepsy, as well as explore the effects of 4 months of treatment with CPAP therapy on cognitive functioning and seizures occurrence. We predict that epilepsy patients with OSA will show worse general cognitive functioning and that use of CPAP therapy in those patients will lead to improved cognitive performance and seizure control after 4 months of treatment. Our findings will lead the way to a better understanding of the mechanisms triggering seizures and cognitive impairments in epilepsy, and are likely to have a very high impact on morbidity, mortality, and quality of life in those patients. This study will certainly highlight the importance of early treatment of sleep apnea in epilepsy patients to prevent further cognitive difficulties.