We all know that sleep is essential for good health, but for millions of people with sleep apnea, getting quality rest can be a challenge. While sleep apnea is commonly associated with daytime fatigue, snoring, and cardiovascular issues, there’s growing evidence of another concerning connection—a potential link to seizures. This relationship is particularly important if you or a loved one experiences either condition, as understanding the connection could lead to better treatment outcomes and improved quality of life.
What is Sleep Apnea?
Sleep apnea is a common but serious sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. These breathing disruptions, which can occur dozens or even hundreds of times per night, prevent your body from getting enough oxygen and often cause you to wake up briefly.
There are three main types of sleep apnea:
- Obstructive Sleep Apnea (OSA): The most common form, caused by a blockage of the airway, typically when the soft tissue at the back of the throat collapses during sleep.
- Central Sleep Apnea: Less common and involves the brain failing to signal the muscles that control breathing.
- Complex Sleep Apnea: A combination of both obstructive and central sleep apnea.
According to research published in Practical Neurology, OSA affects approximately 10% of women and 25% of men in the general population.
Symptoms and Risk Factors
Common Symptoms of Sleep Apnea
The symptoms of sleep apnea can be easy to miss, especially since they occur during sleep. However, there are several warning signs to watch for: loud snoring, episodes of stopped breathing (often reported by another person), gasping for air, morning headaches, excessive daytime sleepiness, irritability, and difficulty concentrating.
Risk Factors
Excess weight is a primary risk factor, as fat deposits around the upper airway can obstruct breathing. Other factors include thick neck circumference, family history, being male, older age, use of alcohol or sedatives, smoking, and nasal congestion. For individuals with epilepsy, the risk of comorbid OSA increases with late-onset or refractory seizures and higher BMI, as noted in Practical Neurology.
How Sleep Apnea May Trigger Seizures
The relationship between sleep apnea and seizures is complex and multifaceted. Studies have found that people with epilepsy are more likely to also have sleep apnea, suggesting a strong correlation.
According to SleepApnea.org, poor sleep quality caused by OSA—such as fragmented sleep and reduced time in restorative sleep stages—can trigger seizures, especially in those already prone to epilepsy. People with sleep apnea also tend to spend more time in lighter stages of sleep, which are more seizure-prone.
A 2023 review published in Frontiers in Neurology via PMC explains that intermittent hypoxia (periods of low oxygen) during sleep can lead to oxidative stress and hippocampal cell loss—both of which may contribute to seizure activity.
Cardiovascular impacts are another factor. Irregular heart rhythms, restricted blood flow, and reduced oxygen supply to the brain caused by untreated sleep apnea may further heighten the risk of seizures.
Research from the Epilepsy Foundation also notes that the relationship is likely bidirectional—not only can sleep apnea trigger seizures, but seizures (and some anti-seizure medications) may worsen sleep apnea.
Diagnosis Methods
If you suspect you might have sleep apnea, especially if you also experience seizures, getting properly diagnosed is essential.
Sleep Study (Polysomnography)
The gold standard for diagnosing sleep apnea is an overnight sleep study, or polysomnography. According to SleepApnea.org, this test tracks vital signs like brain waves, heart rate, and breathing—and can detect both sleep apnea and sleep-related seizures.
Home Sleep Tests
For some patients, especially those without complicating conditions, home-based tests may suffice. These monitor breathing, oxygen levels, and heart rate.
Screening Questionnaires
Tools like the STOP-BANG questionnaire are used to screen for OSA. A study cited in Practical Neurology found that 31.2% of 405 epilepsy patients screened met the criteria for elevated risk.
Comprehensive Assessment
For those with epilepsy, a multidisciplinary evaluation may include:
- Sleep history and physical exam
- Medication review
- Video-EEG monitoring to distinguish seizures from apnea-related arousals
Treatment Options
There’s encouraging news—treating sleep apnea can reduce seizure frequency in people with epilepsy.
CPAP Therapy
Continuous Positive Airway Pressure (CPAP) therapy is the first-line treatment for moderate to severe OSA. According to the Epilepsy Foundation, patients treated with CPAP were significantly more likely to experience a ≥50% reduction in seizures (63%) compared to untreated individuals (14%).
CPAP works by delivering a steady stream of pressurized air through a mask to keep airways open overnight.
Lifestyle Changes
Managing weight, avoiding alcohol and sedatives, quitting smoking, and sleeping on your side can improve sleep apnea symptoms. These changes may also indirectly support better seizure control.
Other Treatment Options
Other therapies include oral appliances, positional therapy, nasal decongestion treatment, and surgical interventions for airway obstructions.
Tips and Strategies for Living with Sleep Apnea
Communication with Healthcare Providers
Make sure all your doctors know about both conditions. The Epilepsy Foundation reports that sleep disorders are often underdiagnosed in people with epilepsy—so don’t dismiss symptoms like daytime drowsiness.
Stick to Your Treatment Plan
Consistency with both CPAP and antiepileptic medications is key.
Prioritize Good Sleep Hygiene
Establishing a consistent bedtime, minimizing blue light exposure, and avoiding stimulants can all improve sleep quality.
Track Your Symptoms
Keeping a detailed log of your sleep quality and seizure activity can help your providers fine-tune your treatment plan.
Why Understanding the Connection Matters
The connection between sleep apnea and seizures underscores the importance of integrated care. The Epilepsy Foundation estimates that 30–40% of people with epilepsy continue to experience seizures despite medical therapy. Identifying and treating underlying sleep disorders like sleep apnea could unlock better outcomes.
If you or a loved one has epilepsy and experiences symptoms like snoring or unrefreshing sleep, talk to your provider about sleep apnea testing. And if you’ve been diagnosed with sleep apnea and experience seizure-like episodes, further neurological evaluation is recommended.
Addressing sleep apnea isn’t just about better sleep—it could be a powerful piece in improving brain health and reducing seizure risk.
