Epilepsy is associated with impaired sleep quality, insomnia and sleepiness

Sleep disturbances are commonly associated with epilepsy and have been shown to reduce the quality of life of patients with epilepsy.1 Korean researchers led by Hee-Jin Im, conducted a cross-sectional case-study and recruited patients aged ≥20 years of age with focal or generalised epilepsy at an epilepsy clinic in Seoul between July 2012 and June 2013.1

180 patients with epilepsy participated in the study and completed structured questionnaires on sleep and epilepsy-related factors, including:1

  • Epworth Sleepiness Scale to determine excessive daytime sleepiness
  • Pittsburgh Sleep Quality Index
  • Insomnia Severity Index
  • Goldberg anxiety scale
  • Patient Health Questionnaire.

The majority of subjects had focal epilepsy (76.1%), and 8.9% had generalized epilepsy; 15% of subjects had unclassified epilepsy.1

The control group comprised 2836 people from the general population who had participated in a health survey and a face-to-face interview in 2010.1

Twice as many people with epilepsy reported sleep disturbances compared with controls (53.3% vs 25.5%; p<0.001).1

In detail, people with epilepsy had a higher frequency of poor sleep quality, excessive daytime sleepiness and insomnia than the general population (p<0.001 for all).1

After adjusting for other covariates such as depressive mood and anxiety, epilepsy remained significantly associated with poor sleep quality (odds ratio [OR] 3.52; 95% confidence interval [CI] 2.45–5.05), excessive daytime sleepiness (OR 2.10; 95% CI 1.41–3.12) and insomnia (OR 5.91; 95% CI 3.43–10.16).1

Excessive daytime sleepiness was nearly twice as common in people with epilepsy compared with controls (21.7% vs 11.9%; p<0.001).1

Depressive mood and anxiety were more strongly associated with sleep disturbances than with epilepsy itself.1 However, the number of anti-epileptic drugs and type of epilepsy were not associated with sleep problems.1

The authors highlighted the importance of screening for sleep problems in patients with epilepsy to facilitate early intervention.1 Further research on potential therapeutic implications of the interplay between the improvement of sleep and seizure control is required.1

Reference list

  1. Im HJ, Park SH, Baek SH, Chu MK, Yang KI, Kim WJ, et al. Associations of impaired sleep quality, insomnia, and sleepiness with epilepsy: A questionnaire-based case-control study. Epilepsy Behav 2016; 57(Pt A): 55–59.

EA/LTG/0005/17 - March 2017