What is it about?

The frequency of sleep disturbances in patients with epilepsy and their impact on quality of life (QoL) have been documented in a few reports, and the results are conflicting. We identified 124 consecutive epilepsy out-patients who visited the epilepsy out-patient clinics at the University Hospital of Alexandroupolis, the AHEPA Hospital in Thessaloniki and the Aeginitio Hospital in Athens. We measured excessive daytime sleepiness (EDS) with the Epworth Sleepiness Scale (ESS), obstructive sleep apnea (OSA) with the Sleep Apnea scale of the Sleep Disorders Questionnaire (SASDQ), and insomnia with the Athens Insomnia Scale (AIS). We evaluated quality of life by the Quality of Life in Epilepsy Inventory (QOLIE-31). EDS was found in 16.9% (21/ 124) of epileptic patients, OSA in 28.2% (35/124), and insomnia in 24.6% (30/122). In multivariate analysis, we found that insomnia was an independent negative factor for Total score ( p < 0.001), Overall QoL ( p = 0.002), Emotional well-being ( p < 0.001), Energy/fatigue ( p < 0.001), Cognitive functioning ( p = 0.04) and Social functioning ( p = 0.03), and OSA only for Cognitive functioning ( p = 0.01). According to our findings, EDS, OSA, and insomnia are frequent in epileptic patients.Epileptic patients with sleep disturbance, mainly insomnia, have significant QoL impairment.

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Why is it important?

The present study showed that EDS and OSA, but not insomnia, are more frequent in patients with epilepsy than in the general population. Mainly insomnia and, secondarily, OSA were found as independent negative factors of QOL in patients with epilepsy.

Perspectives

In summary, the results of our study add further data about the frequency and type of sleep disturbances in patients with epilepsy and the impact of these on QoL. We believe that longitudinal studies and objective sleep tests (i.e. polysomnography, MSLT) are needed to establish these findings. Nevertheless, we suggest that clinical recognition and treatment of sleep disturbances is important for the improvement of QoL in patients with epilepsy.

Professor Stavros J Baloyannis or Balogiannis or Balojannis or Baloyiannis or Mpalogiannis
Aristotle University of Thessaloniki

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This page is a summary of: Influence of sleep disturbance on quality of life of patients with epilepsy, Seizure, October 2008, Elsevier,
DOI: 10.1016/j.seizure.2008.02.005.
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