Fatigue in patients with epilepsy and its association with depression and sleep quality

Abstract

OBJECTIVE: It was to evaluate the relationships between fatigue and excessive daytime sleepiness, sleep quality, depression and anxiety. METHODS: This was a cross-sectional study on 98 unselected adult patients with epilepsy (PWE) at a tertiary center. It used clinical-sociodemographic characteristics, fatigue measured by the SF-36 vitality subscale (VsSF-36) and the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and Beck Depression and Anxiety Inventories. RESULTS: We observed that our patients presented vitality or fatigue similar to drivers with chronic headaches evaluated in the same city. Fatigue was related to depression, anxiety and sleep quality, but not to daytime sleepiness. A multiple linear regression analysis was conducted and we observed that fatigue was independently correlated with depression and quality of sleep. However, no significant difference was observed regarding seizure frequency or number of antiepileptic drugs. CONCLUSION: Fatigue needs to be studied more in PWE, and its risk factors need to be controlled, along with sleep quality and psychiatric disorders.

Interictal fatigue and its predictors in epilepsy patients: A case-control study

“…A previous study found that the severity of fatigue is higher in epilepsy patients than in healthy controls but the numbers of subjects in each group in that study were relatively small [1]. The present study included 270 epilepsy patients and 200 healthy control subjects, which is a greater number of participants than included in other studies investigating fatigue in epilepsy patients [1,16,17]. This may render the differences in fatigue observed in epilepsy patients and controls in the present study more reliable and valid.…”

“…Two previous studies found that sleep-related problems are crucial predictors of fatigue in epilepsy patients, but the particular aspects of the sleep-related problems differ among studies. Neves et al [16] included sleep quality and daytime sleepiness as candidate variables in their analysis and found that sleep quality, but not daytime sleepiness, was a significant predictor of fatigue in epilepsy patients. In contrast, Hamelin et al [17] found that daytime sleepiness was an important predictor of fatigue in epilepsy patients, although this study did not include sleep quality as a candidate predictor.…”

“…Epilepsy and depression have a bidirectional relationship and, as a corollary of this relationship, depression is often comorbid with epilepsy. It has been found that 9-37% of epilepsy patients suffer from depression [32], and several studies have shown that fatigue in epilepsy patients is determined by the presence of depression [9,16]. Neves et al [16] determined that depression and sleep quality are significant predictors of fatigue in epilepsy patients and that the effects of depression are stronger than those of sleep quality.…”

“…It has been found that 9-37% of epilepsy patients suffer from depression [32], and several studies have shown that fatigue in epilepsy patients is determined by the presence of depression [9,16]. Neves et al [16] determined that depression and sleep quality are significant predictors of fatigue in epilepsy patients and that the effects of depression are stronger than those of sleep quality. In the present study, sleep-related impairments, but not sleep quality, was a significant predictor of fatigue, and this effect was 2.27 times stronger than that of depression.…”

“…Likewise, studies investigating the predictors of fatigue in epilepsy patients are also relatively rare. Although several studies have shown that fatigue in epilepsy patients is related to sleep quality, depression, and anxiety [1,12,16,17], the variables associated with epilepsy, including seizure types, seizure freedom, and factors related to antiepileptic drugs (AEDs), have not been correlated with fatigue [1,[16][17][18]. Of these studies, one [1] observed a tendency for increased fatigue based on the number of AEDs or the number of seizures, but without statistical significance.…”