Sleep disturbance in epilepsy linked to affective disorders, reduced quality of life

People with epilepsy often experience sleep disturbance, which is linked to other problems such as anxiety and depression and negatively affects quality of life (QoL), according to a study from Germany. 

The study included 449 adults (mean age 39.9 years, 58.1 percent female) with epilepsy. Outcomes of interest including sleep quality, affective symptoms, and epilepsy-specific QoL were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS), and the 31-item Quality of Life in Epilepsy (QOLIE-31) inventory, respectively.

Analyses were conducted to evaluate sociodemographic and clinical predictors of sleep quality and QoL. Results were compared with normative data from the general German population and individuals with chronic migraine.

A total of 221 participants (49.2 percent) were categorized as “poor sleepers,” and this number was significantly higher than that recorded in the general population (35.9 percent; p<0.001).

In multivariable analysis, poor sleep quality showed an independent association with female sex (odds ratio [OR], 2.02, 95 percent confidence interval [CI], 1.36–3.01; p=0.001), unemployment (OR, 1.74, 95 percent CI, 1.10–2.73; p=0.017), anxiety (OR, 3.79, 95 percent CI, 2.39–6.04; p<0.001), and depression (OR, 2.19, 95 percent CI, 1.36–3.54; p=0.001). Moreover, daily seizures increased the odds of having worse sleep quality by more than twofold (OR, 2.55, 95 percent CI, 1.03–6.30; p=0.042).

Poor sleep independently correlated with lower epilepsy-related QoL in an analysis adjusted for affective symptoms and seizure frequency (OR, 1.79, 95 percent CI, 1.20–2.68; p=0.005).

These data underscore the importance of routine screening for affective symptoms and sleep disturbances in epilepsy care.