Sleep duration, quality predict seizure recurrence in newly treated epilepsy

Sleep duration and sleep quality have an independent and joint association with the risk of seizure recurrence among patients with newly treated epilepsy, according to a study.

The prospective cohort study included 209 patients who were treated at a comprehensive epilepsy centre in northeast China. All patients self-reported sleep duration and sleep quality and were followed for 12 months for recurrent seizures.

Cox proportional hazard regression models were used to estimate association between the sleep parameters and seizure recurrence. Models fitted with restricted cubic spline were performed to test for linear and nonlinear shapes of each association.

Of the patients, 103 experienced seizure recurrence during follow-up. Baseline short sleep was significantly associated with increased risk of seizure recurrence (adjusted hazard ratio [aHR], 2.282, 95 percent confidence interval [CI], 1.436–3.628; p<0.001). A significant nonlinear U-shaped association was observed between sleep duration (h/day) and recurrent seizure risk, with a nadir at 8 h/day.

Baseline poor sleep quality also showed a significant association with greater risk of seizure recurrence (aHR, 1.985, 95 percent CI, 1.321–2.984; p<0.001). There was a positive linear association between Pittsburgh Sleep Quality Index score and seizure recurrence risk.

Notably, a combination of poor quality–short sleep duration was associated with a threefold increased risk of seizure recurrence compared with good quality–intermediate sleep duration reference (aHR, 3.13, 95 percent CI, 1.779–5.507; p<0.001).