Sleep and Breathing

, Volume 19, Issue 2, pp 421–432 | Cite as

Sleep apneas and epilepsy comorbidity in childhood: a systematic review of the literature

  • Maria Gogou
  • Katerina Haidopoulou
  • Maria Eboriadou
  • Evaggelos Pavlou



Our aim is to review studies which assess the prevalence of sleep apneas in children with epilepsy and discuss possible mechanisms linking these two conditions, as well as the impact of sleep apneas on the prognosis of these children.


PubMed was used as the medical database source, and articles were selected and classified according to their originality, level of evidence, and relevance to the broad scope of the review.


Children with epilepsy have a higher prevalence of sleep breathing disorders in comparison to healthy children, but this prevalence varies widely depending on the methodology of each study. Major risk factors for sleep apneas in childhood epilepsy include mainly poor seizure control and antiepileptic drug polytherapy. Indeed, epilepsy can trigger sleep apneas, as abnormal electrical discharge amplifies sleep-induced breathing instability, antiepileptic drugs disturb muscle tone, and vagus nerve stimulation modulates neurotransmission to airway muscles. On the other hand, sleep apneas enhance sleep fragmentation, thus reducing the threshold for the appearance of seizures. Moreover, they have a negative effect on the neurocognitive profile of these children, as they disturb neuroplasticity mechanisms and also have a probable association with sudden unexpected death in epilepsy. The surgical treatment of sleep apneas has been found to reduce seizure frequency, and this can offer new therapeutic choices.


Between sleep apneas and childhood epilepsy, there is a complex relationship with reciprocal interactions. The presence of sleep apneas should be taken into account when designing the management of these children, as it creates therapeutic opportunities and limitations.


Sleep Apneas Epilepsy Children Antiepileptic drugs Cognitive function 



Sleep apneas


Obstructive apnea-hypopnea index


Obstructive sleep apnea (syndrome)


Obstructive sleep apnea-hypopnea syndrome


Sleep breathing disorder(s)


Antiepileptic drug(s)


Vagus nerve stimulation


Sudden unexpected death in epilepsy


Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Maria Gogou
    • 1
    • 3
  • Katerina Haidopoulou
    • 2
  • Maria Eboriadou
    • 2
  • Evaggelos Pavlou
    • 1
  1. 1.2nd Department of Pediatrics, School of MedicineAristotle University of Thessaloniki, University General Hospital of Thessaloniki AHEPAThessalonikiGreece
  2. 2.4th Department of Pediatrics, School of MedicineAristotle University of Thessaloniki, General Hospital of Thessaloniki PapageorgiouThessalonikiGreece
  3. 3.KateriniGreece

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