OBJECTIVE: This study was designed to assess the prevalence of sleep and mood disturbances and their impact on quality of life (QoL) in a real-life cohort of people with epilepsy (PwE) followed at a tertiary epilepsy center using self-reported assessments.
METHODS: PwE completed a battery of questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index, Berlin Questionnaire, International Restless Leg Syndrome Study Group rating scale, Epworth Sleepiness Scale (ESS), Morningness-Eveningness self-assessment (MEQ-SA), Generalized Anxiety Disorder-7, Neurological Disorders Depression Inventory for Epilepsy, and QoL in Epilepsy (QOLIE-31). Subgroup analyses were performed to investigate differences according to seizure type, epilepsy etiology, treatment response, and daily drug load.
RESULTS: A total of 386 PwE were included. More than half (60.4%, n = 233) of the sample reported at least one sleep complaint, with poor sleep quality and insomnia being the most prevalent. Almost twenty-five percent (25.6%, n = 99) of PwE reported insomnia. Symptoms of depression were present in 20.2% of PwE (n = 78); 16.8% of PwE reported moderate or severe anxiety (n = 65). Patients with generalized epilepsy showed higher insomnia severity, longer sleep latency (PSQI, C2), and increased daytime sleepiness (ESS), alongside lower MEQ-SA scores, suggesting an evening chronotype. Patients with structural epilepsy showed greater seizure worry, worse social functioning, and lower overall QoL compared to PwE of unknown etiology. Response to treatment was associated with better social functioning and improved QoL, but not with a better sleep-wake cycle pattern. Polytherapy was associated with higher seizure worry, worse emotional and social well-being, as well as lower overall QoL scores.
SIGNIFICANCE: This study found a high prevalence of subjective sleep problems in PwE, more frequently than mood disturbances. This highlights the importance of comprehensive care for PwE that also addresses the characteristics of the sleep-wake cycle, as these are core determinants of QoL.
