Sleep quality and impact factors in older adults with epilepsy

Yilin Fan; Xiaowen Zhou; Honglu Ping; Yiling Chen; Qianhua Zhao; Ding Ding; Jianhong Wang

doi:10.1016/j.yebeh.2026.110889

Sleep quality and impact factors in older adults with epilepsy

Epilepsy Behav. 2026 Jan 18:176:110889. doi: 10.1016/j.yebeh.2026.110889. Online ahead of print.

Authors

Yilin Fan¹, Xiaowen Zhou¹, Honglu Ping¹, Yiling Chen¹, Qianhua Zhao¹, Ding Ding¹, Jianhong Wang²

Affiliations

¹ Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China; National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China.
² Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China; National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China. Electronic address: wang_jianhong@fudan.edu.cn.

PMID: 41554220
DOI: 10.1016/j.yebeh.2026.110889

Abstract

Objective: This study aimed to describe sleep quality and the prevalence of poor sleepers in older adults with epilepsy (OAE), and to identify epilepsy-related factors associated with sleep quality.

Method: We conducted a case-control study including 175 OAE and 700 older adults without epilepsy. Demographic characteristics, clinical conditions, and epilepsy-related factors were collected. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), with scores > 5 indicating poor sleep.

Results: OAE had significantly higher global PSQI scores than controls (6.1 [3.3] vs. 4.6 [3.2], p < 0.001), with 48.6 % classified as poor sleepers compared to 19.9 % in controls (p < 0.001). OAE had longer sleep latency, shorter sleep duration, lower sleep efficiency, more sleep disturbances, higher frequency of sleeping medication use, and greater daytime dysfunction (all p < 0.05). Poor sleepers in the OAE group exhibited shorter sleep duration, more severe sleep disturbances, and daytime dysfunction (p < 0.05) compared with controls. Multivariate linear regression models indicated that, epilepsy onset at older age was associated with greater sleep disturbances (β = 0.006, p = 0.005) and less sleep medication use (β = -0.011, p = 0.009); longer epilepsy duration was correlated with fewer sleep disturbances (β = -0.006, p = 0.006) and more sleep medication use (β = 0.011, p = 0.008); higher seizure frequency was associated with longer sleep duration (β = -0.228, p = 0.023).

Conclusion: OAE exhibited significantly poorer sleep quality compared to controls, with sleep disturbances closely linked to epilepsy-related factors. These findings underscore the need for comprehensive sleep assessment and management of seizures in clinical care for OAE, with the goal of improving their overall health outcomes.

Keywords: Epilepsy; Older adults; Pittsburgh Sleep Quality Index; Sleep quality.