Subjective Sleep Disorders In Adults With Epilepsy And Relations With Depression And Anxiety

Objective Epilepsy is a very common neurological condition.Due to the complexity of pathogenesis and clinical manifestation and use of AEDs,patients with epilepsy face many problems and symptoms that affect daily life and place a significant burden on patients and their family.Sleep disorders are the most common complaint in patients with epilepsy.Furthermore,depression and anxiety are both very frequent psychiatric disorders in epilepsy patients.We conducted a cross-sectional survey of adults with epilepsy,the aim of this study were(1)to analyze sleep disorders in patients with epilepsy(2)to explore the impact of clinical features and depressive and anxiety related symptoms on sleep disorders.Methods 150 adults with epilepsy were compared with 100 age-and gender-matched healthy controls.All patients and 100 normal ones were completed Pittsburgh Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS),Insomnia Severity Index(ISI),Restless legs syndrome(RLS),Beck Depression Inventory-?(BDI-?),Beck anxiety Inventory(BAI)and Mini-Mental State Examination(MMSE).The partial correlation and hierarchical regression analysis were used to explore the impact of seizure-related or demographic variables and depressive and anxiety related symptoms on sleep disturbances.Results The scores of adults with epilepsy in PSQI,ISI,BDI-?and BAI((4.02±2.50),(9.28±6.30),(11.16±5.57)and(10.25±5.33),respectively)were significantly high than those of the control groups((3.29 ± 2.33),(7.23 ± 3.83),(6.56 ± 3.84)and(8.76 ±5.01),respectively))(p < 0.01).Use of lamotrigine(LTG)was also related with ISI and use of clonazepam(CZP)and phenobarbital(PB)were associated with ESS in patients with epilepsy;The partial correlation and hierarchical regression analysis showed that BDI-? and BAI independently exert an adverse effect on the subjective sleep quality(PSQI)and insomnia(ISI)of patients.In addition,seizure control,partial seizures,and the duration of epilepsy were also associated with PSQI and ISI in patients with epilepsy,but seemed less powerful predictors of sleep quality and insomnia than affective symptoms.However,age,gender,marital status and the number of AEDs were not related to sleep disturbances.Conclusion Adults with epilepsy have a higher prevalence of insomnia and experienced poorer sleep quality than the control group.Depressive-and anxiety-related symptoms independently affect the insomnia and impair patients' sleep quality.In addition,seizure control,partial seizures,and the duration of epilepsy also affect the sleep quality and insomnia of patients.Hence,early identification and treatment of affective symptoms is of great importance in improving the sleep quality in adults with epilepsy.