Coffee may guard against seizure‐related respiratory dysfunction

Coffee drinkers are less likely to have seizure‐related respiratory dysfunction, with a dose‐dependent effect, as compared with abstainers, a study reports.

The cross‐sectional analysis included 90 patients with drug‐resistant focal epilepsy, with 323 seizure episodes. All of them had data on focal seizure (FS), valid pulse oximetry (SpO₂) measurement, and usual coffee consumption. The latter was obtained using a standardized self‐questionnaire and further classified into the following: none, rare (≤3 cups/week), moderate (4 cups/week to 3 cups/day), and high (≥4 cups/day).

Peri‐ictal hypoxemia (PIH), defined as SpO₂ <90 percent for at least 5 seconds, was independently associated with the level of usual coffee consumption (p=0.033) and the antiepileptic drug withdrawal (p=0.004).

Relative to FS in patients who never consumed coffee, the risk of PIH was four times lower in FS in patients with moderate intake (odds ratio [OR], 0.25, 95 percent confidence interval [CI], 0.07–0.91; p=0.036) and six times lower in FS in those with high intake (OR, 0.16, 95 percent CI, 0.04–0.66; p=0.011).

However, when PIH occurred, the duration was significantly longer in patients with moderate or high coffee intake than in nonconsumers (p=0.042).

Caffeine interferes with the adenosine pathway, which is involved in regulation of breathing. In the immediate aftermath of a seizure, extracellular concentrations of adenosine are high. Seizure‐related overstimulation of adenosine receptors can promote peri‐ictal apnoea.