Yonsei medical journalNov 25, 2025

Sleep characteristics may influence the risk of epilepsy and vice versa.

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jun 27, 2026

Abstract

Essence

Genetic evidence suggests insomnia may increase generalized epilepsy risk, while other sleep-epilepsy links weakened after adjustment.

Evidence

This bidirectional two-sample study used published GWAS data for seven sleep traits and epilepsy outcomes, with multivariable analysis linking insomnia to generalized epilepsy risk (=5.214, 95% CI 1.384-19.639).

Caveat

Chronotype and focal epilepsy-to-napping associations lost causal support after adjustment, and Mendelian randomization depends on genetic instruments rather than direct intervention data.

Simplified

PURPOSE: Sleep traits are suggested as risk factors for epilepsy, yet the extent of their shared biological basis and the causal direction between these traits are not well understood. Our goal was to assess the associations and establish causal relationships between sleep traits and epilepsy through (MR) analyses.

MATERIALS AND METHODS: Univariate and multivariate bidirectional MR analyses were used to assess the causal association between sleep traits and epilepsy. In this study, exposure factors of seven sleep traits and outcome variables related to epilepsy were obtained from the published Genome-Wide Association Study (GWAS). The major analysis utilized for MR was inverse-variance weighted.

RESULTS: Univariable MR analysis indicated that both insomnia and chronotype were positively associated with the risk of generalized epilepsy (GE) [ (OR)=3.436, 95% confidence interval (CI): 1.081-10.919,=0.036; OR=1.645, 95% CI: 1.054-2.566,=0.028]. Additionally, a positive association was found between focal epilepsy (FE) and the risk of daytime napping (OR=1.003, 95% CI: 1.001-1.006,=0.011). Multivariable MR analysis demonstrated that insomnia was causally and positively linked to GE (OR=5.214, 95% CI: 1.384-19.639,=0.015). However, after adjusting for other sleep traits and potential confounders, chronotype was found to have no causal effect on GE. Similarly, no causal relationship was found from FE to daytime napping when adjusted for potential confounders. p p p p

CONCLUSION: Our results suggest a shared genetic foundation between sleep traits and epilepsy, indicating potential causal effect of insomnia on GE risk. Interventions targeting sleep disturbances could serve as therapeutic approaches in epilepsy management.

Key numbers

5.214

Causal Increase in GE Risk

for insomnia's effect on generalized epilepsy

1.003

Positive Association with Daytime Napping

for daytime napping's effect on focal epilepsy

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Sleep characteristics may influence the risk of epilepsy and vice versa.

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