Purpose of this Review <p>This manuscript presents a broad overview of the implications of obstructive sleep apnea (OSA) co-occurring with epilepsy. We present the reader with data on epidemiology and shared pathophysiology of these conditions. We further discuss the consequences of untreated OSA on epilepsy, as well as the benefits of identification and treatment of OSA for epilepsy outcomes. Lastly, we discuss the range of treatment considerations for OSA in the setting of epilepsy.</p> Recent Findings <p>A large, multicenter, multinational database study found that children with epilepsy and sleep apnea were at significantly higher risk for sudden cardiac arrest compared with children with epilepsy alone or sleep apnea alone, with adenotonsillectomy significantly reducing this risk. This finding is consistent with other recent observational studies demonstrating a higher risk of mortality and SUDEP in people with epilepsy (PWE) who have OSA. These studies add to the growing evidence of severe morbidity and mortality associated with OSA in PWE and indicate a need for improved identification and treatment of OSA in this population.</p> Summary <p>Epilepsy and sleep disorders have a complex, often bidirectional relationship. Both epilepsy and OSA are common disorders but co-occur more often than would be expected if these disease processes were unassociated. Adding to this, each disorder, when untreated, has negative consequences on the other, while treatment of one disorder may result in a positive or negative impact on both conditions. In this review, we describe the epidemiology of both diseases, the effect of OSA on seizure outcomes in epilepsy, and strategies for management of OSA in epilepsy. </p>