Sleep-wake habits and disorders in a series of 100 adult epilepsy patients—A prospective study

Abstract

The aim of the study was to assess sleep-wake habits and disorders and excessive daytime sleepiness (EDS) in an unselected outpatient epilepsy population. Sleep-wake habits and presence of sleep disorders were assessed by means of a clinical interview and a standard questionnaire in 100 consecutive patients with epilepsy and 90 controls. The questionnaire includes three validated instruments: the Epworth Sleepiness Scale (ESS) for EDS, SA-SDQ for sleep apnea (SA), and the Ullanlinna Narcolepsy Scale (UNS) for narcolepsy. Sleep complaints were reported by 30% of epilepsy patients compared to 10% of controls (p=0.001). The average total sleep time was similar in both groups. Insufficient sleep times were suspected in 24% of patients and 33% of controls. Sleep maintenance insomnia was more frequent in epilepsy patients (52% vs. 38%, p=0.06), whereas nightmares (6% vs. 16%, p=0.04) and bruxism (10% vs. 19%, p=0.07) were more frequent in controls. Sleep onset insomnia (34% vs. 28%), EDS (ESS >or=10, 19% vs. 14%), SA (9% vs. 3%), restless legs symptoms (RL-symptoms, 18% vs. 12%) and most parasomnias were similarly frequent in both groups. In a stepwise logistic regression model loud snoring and RL-symptoms were found to be the only independent predictors of EDS in epilepsy patients. In conclusion, sleep-wake habits and the frequency of most sleep disorders are similar in non-selected epilepsy patients as compared to controls. In epilepsy patients, EDS was predicted by a history of loud snoring and RL-symptoms but not by SA or epilepsy-related variables (including type of epilepsy, frequency of seizures, and number of antiepileptic drugs).

Insomnia and Epilepsy: A Questionnaire-Based Study

“…30,31 Khatami and colleagues examined 100 clinic patients with epilepsy and found sleep onset insomnia in 33 of 98 subjects (34%) and sleep maintenance insomnia in 50 of 97 subjects (52%). 17 Lower prevalence of insomnia in epilepsy patients has been reported by Piperidou and colleagues, who found that only 24% of their cohort of 122 subjects suffered from insomnia, as measured with the Athens Insomnia Scale (AIS). 32 We may relate this discrepancy to different assessment instruments.…”

“…(8)(9)(10)(11)(12)(13)(14) 51 (33%) Clinical insomnia (moderate severity) (15)(16)(17)(18)(19)(20)(21) 63 (41%) Clinical insomnia (severe) (22)(23)(24)(25)(26)(27)(28) 15 (10%) Most patients were found to have low depressive scores, and this may be secondary to partial and/or successful treatment. Depression represents one of the most common comorbidities of epilepsy and has profound negative impact on the quality of life of patients.…”

“…[13][14][15] Overall, the available information on the prevalence and the predictors of insomnia in this patient population is limited. [16][17][18] The aims of this study were (1) to analyze the prevalence and degree of insomnia in patients with epilepsy, (2) to examine the clinical features and predictors of insomnia in these patients, and (3) to evaluate the impact of poor sleep on their quality of life.…”

Primary Sleep Disorders in People with Epilepsy

“…Sleep disorders are 2 to 3 times more common in adults [11][12][13][14] and children 1-10 with epilepsy compared with the general age-matched population, especially when their seizures are poorly controlled or complicated by comorbid neurologic conditions.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] AWE and sleep complaints have significantly lower quality of life than those without sleep problems. [11][12][13]15,16 Sleep problems in children and adolescents with epilepsy are associated with negative effects on daytime behavior and academic performance. [17][18][19] Recognition of this situation has led to more patients referred to sleep centers to evaluate whether untreated sleep disorders may be contributing to their seizures.…”