Subjective Sleep Disturbance in People with Epilepsy: Prevalence and Impact on Health-Related Quality of Life

Abstract

Background and Objective It is not well known whether sleep disturbances affect quality of life (QoL) independent of mood disturbance in people with epilepsy. The aim of this study was to investigate the prevalence of sleep disturbances and the impact on QoL in people with epilepsy. Methods This was a cross-sectional study involving adults with epilepsy and controls. Sleep disturbances, depression, anxiety, and QoL were assessed using several questionnaires. The direct effect of sleep disturbance on QoL was assessed using multiple linear regression analysis, and a mediational model designed with the assumption that sleep disturbances affect QoL through a mediator was tested. Results A total of 168 people with epilepsy and 56 controls were enrolled. Difficulty maintaining sleep (16.1%) and waking up too early in the morning (13.1%) were more common in patients than controls (p < 0.05). There were no differences in daytime sleepiness, sleep apnea, and restless legs syndrome between the groups. Patients had more sleep problems in the Medical Outcomes Study-Sleep Scale than controls. The effect of sleep disturbance on Quality of Life in Epilepsy 10 (QOLIE-10) lost its statistical significance (β = −0.021, p = 0.769) after controlling for Hospital Anxiety and Depression Scale (HADS). The Sobel test confirmed that the effect of sleep disturbance on QOLIE-10 was significantly mediated by both HADS-depression (β = −0.195, p < 0.001) and HADS-anxiety (β = −0.265, p < 0.001). Conclusions Sleep disturbances, especially insomnia, were more common in people with epilepsy. Although sleep disturbance seems to have no direct effects on QoL, it appears to have an indirect effect on QoL through depression and anxiety in people with epilepsy.

Keywords

• Epilepsy
• Sleep disturbance
• Insomnia
• Quality of life
• Depression