Four patients, diagnosed with refractory epilepsy, were treated with both continuous positive airway pressure (CPAP) and antiepileptic medication (AEM) and showed > 50% reduction in seizures after 6 months-2 years follow-up. Two patients subsequently had AEM withdrawn and are seizure free and in one such patient, obstructive sleep apnoea (OSA) has remained the only operative diagnosis. This dual approach to care provided a real advantage to the management of patients with the dual diagnoses of OSA and epilepsy, which was refractory to standard AEM therapy.