Insomnia and poor sleep quality are associated with poor seizure control in patients with epilepsy

Neurologia (Engl Ed). 2022 Oct;37(8):639-646. doi: 10.1016/j.nrl.2019.07.006. Epub 2020 Jan 11.
[Article in English, Spanish]


Objectives: This study aimed to assess the presence of sleep disorders in patients with epilepsy and to analyse their association with seizure control.

Methods: We performed a cross-sectional study of patients with epilepsy, recruited consecutively between September 2017 and December 2018. Patients were classified as having good seizure control (no seizures in the last 4 weeks) or poor seizure control (at least one seizure in the last 4 weeks). We performed intergroup comparisons for demographic and clinical data, insomnia (Insomnia Severity Index [ISI]), excessive daytime sleepiness (Epworth Sleepiness Scale [ESS]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), depression (Beck Depression Inventory-II [BDI-II]), and quality of life (Quality of Life in Epilepsy Inventory-10 [QOLIE-10]).

Results: The sample included a total of 123 patients, of whom 31.7% had excessive daytime sleepiness (ESS≥10), 50.4% had insomnia (ISI≥10), and 53.6% had poor sleep quality (PSQI≥5). According to our multivariate analysis, presence of seizures was associated with unemployment (odds ratio [OR]=4.7; 95% confidence interval [CI], 1.36-19.2; P=.02), a higher number of antiepileptic drugs (OR=5.87; 95% CI, 1.81-27.1; P<.001), insomnia (OR=1.9; 95% CI, 1.1-9.3; P=.04), and poor sleep quality (OR=2.8; 95% CI, 1.9-10.32; P=.01).

Conclusions: Sleep disorders are common in patients with epilepsy. Insomnia and poor sleep quality were associated with poor seizure control. These findings support the hypothesis that sleep disorders constitute a significant comorbidity of epilepsy, especially in patients with poor seizure control.

Keywords: Calidad de sueño; Control de crisis; Epilepsia; Epilepsy; Hipersomnia; Hypersomnia; Insomnia; Insomnio; Seizure control; Sleep quality.

MeSH terms

  • Cross-Sectional Studies
  • Disorders of Excessive Somnolence*
  • Epilepsy* / complications
  • Humans
  • Quality of Life
  • Seizures / epidemiology
  • Sleep Initiation and Maintenance Disorders* / complications
  • Sleep Initiation and Maintenance Disorders* / epidemiology
  • Sleep Quality