How are epileptic events linked to obstructive sleep apneas in epilepsy?

Obstructive sleep apnea (OSA) is common in patients with refractory epilepsy and may exacerbate seizures. In epileptic patients with OSA, seizures occur more frequently during sleep. Seizure frequency may be reduced by treating OSA and increase if the treatment is interrupted or neglected. It is not clear how OSA provokes seizures. Multiple seizureprovoking factors including cerebral hypoxemia, sleep deprivation and sleep fragmentation might be involved. The temporal link between OSA and seizures or interictal events might be better understood with careful analysis of video EEG (vEEG) records. Such data has never been precisely reported. We report here a direct relation between OSA and both ictal and interictal epileptic events during vEEG investigations in a patient with temporal lobe epilepsy.