Depression is a major determinant of sleep abnormalities in patients with epilepsy

Abstract

Introduction: We aimed to identify sleep disorders in patients with epilepsy and compare this group with a healthy population. We also analyzed the features of sleep disorders in patients with epilepsy to demonstrate the effect of seizures and seizure types on sleep. Methods: Our study assessed 43 patients with epilepsy and 53 age- and gender-matched healthy controls. The demographic and clinical data of all participants were recorded. The Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), International Restless Legs Syndrome Study Group Rating Scale, Berlin Questionnaire, and Beck Depression Inventory (BDI) were administered to all study subjects. The interview used to evaluate insomnia is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition - DSM-5 diagnostic criteria. Results: Twenty-four patients (55.8%) and 26 controls (49.1%) are women. The mean age of patients and controls was 34.2±11.37 (16-71) and 34.6±11.28 (16-77), respectively. Patients with epilepsy had depression more often than controls, a result that was statistically significant (p<0.0001). We found no statistically significant difference between sleep parameters of patients and controls with normal BDI scores (p>0.05). Patients with depression had worse results on the Berlin Questionnaire and PSQI total score, with statistical significance (p=0.002). Nocturnal seizures, seizure type, and drug treatment had no effect on sleep (p>0.05). Conclusion: We concluded that depression rather than epilepsy negatively affects sleep, suggesting that all patients should be asked about their mood and sleep complaints.

Medium‐term changes in patients with epilepsy during the COVID‐19 pandemic

“…Moreover, higher NDDI‐E scores were also associated with sleep disturbance. Depression negatively affects sleep in PWE 31 and sleep deprivation is a known precipitating factor for seizures 32 . Therefore, higher levels of depression, in association with sleep disturbances, could explain worsening seizure frequency in some PWE during the confinement 26 …”

Os Transtornos Mentais Associados a Pacientes Com Epilepsia: Revisão De Estudos Publicados De 2011 a 2021

“…As crises focais diurnas são as mais responsáveis pela diminuição do padrão adequado do sono, aliado a outros fatores como apneia do sono noturno e a privação do sono, estão entre os distúrbios mais comuns que afetam diretamente a qualidade do sono e, podem desencadear crises convulsivas. A insônia é um dos distúrbios do sono mais frequente em pacientes com epilepsia, influenciando negativamente seu humor (KARAPINAR et al, 2020).…”

“…A qualidade de vida dos pacientes é danificada pela perda de padrão de sono, má qualidade do sono, sonolência diurna excessiva e a síndrome das pernas inquietas são extremamente comuns em pacientes com epilepsia, nos pacientes que apresentam depressão e transtornos de humor esses sintomas estão ainda mais presentes (KARAPINAR et al, 2020).…”

Mood Disorders

“…63 Studies suggest that epilepsy can alter the quality of sleep, indirectly affecting mood, but the types of seizures, timing of seizures, and treatment regimen do not result in differences in the overall effect on sleep; rather, it is just the presence or absence of the epileptic episode itself that alters sleep patterns. 64 Stroke Poststroke depression is one of the most frequent neuropsychiatric sequelae that worsen the outcomes in patients with stroke; the prevalence varies from 29% to 36%. 65 The risk of developing poststroke depression is increased in patients who have predisposing medical conditions, history of smoking, and prior psychiatric history and based on stroke characteristics itself.…”

“…The risk of suicide in patients with epilepsy and mood disorders is increased almost 32-fold 63 . Studies suggest that epilepsy can alter the quality of sleep, indirectly affecting mood, but the types of seizures, timing of seizures, and treatment regimen do not result in differences in the overall effect on sleep; rather, it is just the presence or absence of the epileptic episode itself that alters sleep patterns 64 …”