Introduction: Vagus nerve stimulation (VNS) is indicated in cases of refractory epilepsy. Its side effects are frequently minor, however, breathing disturbances during sleep have been previously reported.

Case reports: Our three cases are representative of sleep-disordered breathing that occurred as a consequence of VNS activity in patients with refractory epilepsy. Sleep apnoea was observed in two patients and stridor in one patient.

Conclusions: Given the high prevalence of sleep apnoea-hypopnoea syndrome in patients with refractory epilepsy, implantation of VNS should be ideally preceded by an assessment of the breathing during sleep. Furthermore, sleep-disordered breathing should be considered as a rare complication of VNS, and sleep apnoea should be investigated alongside data regarding VNS firing.

Introducción La estimulación del nervio vago (ENV) es una terapia utilizada en casos de epilepsia refractaria. Sus efectos secundarios son, con frecuencia, leves; sin embargo, se han descrito previamente alteraciones respiratorias durante el sueño.

Casos clínicos Los tres casos incluidos son representativos de alteraciones respiratorias durante el sueño (apnea del sueño y estridor) que surgen a consecuencia de la actividad de la ENV.

Conclusiones Dada la elevada prevalencia del síndrome de apnea/hipopnea durante el sueño en pacientes con epilepsia refractaria, debería estudiarse su posible preexistencia en candidatos a ENV y considerarse su potencial aparición como consecuencia de la ENV en el seguimiento de pacientes con ENV activa.