title: Sleep disorders and circadian rhythm in epilepsy revisited: a prospective controlled study.
abstract: OBJECTIVE
  Sleep disturbance is reported to be frequent in epilepsy. The role of comorbidity, which is frequently accompanied by sleep disturbance, has not been investigated. The present study assessed sleep disorders and circadian rhythm in patients with epilepsy, in whom relevant comorbidity was carefully excluded.
  
  
  METHODS
  Two hundred patients with epilepsy (100 generalized, 100 partial), without relevant psychiatric, neurological or internal comorbidity, were compared with 100 matched controls. The questionnaire contained specifically tailored questions to address the association between epilepsy and sleep disturbance, and validated questionnaires aimed at sleep quality, excessive daytime sleepiness (EDS), circadian rhythm, sleep disorders, and quality of life.
  
  
  RESULTS
  Forty-one percent of the participants reported on the acute effects of present or past seizures on sleep-wake rhythm, whereas chronic effects were not evident. Participants and controls did not differ in the rates of chronic sleep disturbance, EDS, and presence of sleep disorders (all p-values non-significant or n.s.). Apart from earlier sleep times on workdays (p = 0.001) in those with epilepsy, circadian variables were similarly distributed. Epilepsy was well controlled, with 75.9% being seizure free for ≥ 1 year. Longer durations of epilepsy showed a negative correlation with sleep quality (rho = -0.256, p < 0.001). Participants with generalized and partial epilepsies did not differ in rates of sleep disturbance, EDS, sleep disorders, and variables of circadian rhythm (all p-values n.s.).
  
  
  CONCLUSIONS
  The present study demonstrated that chronic sleep disturbance is not increased in patients with well-controlled epilepsy without relevant comorbidity. This supports comorbidity and insufficient seizure control as major contributors of sleep disturbance in epilepsy.
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: Iris
authors: I
authors: Unterberger
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: David
authors: D
authors: Gabelia
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: Manuela
authors: M
authors: Prieschl
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: Kevin
authors: K
authors: Chea
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: Matthias
authors: M
authors: Hofer
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: Birgit
authors: B
authors: Högl
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria.
authors: Gerhard
authors: G
authors: Luef
authors: Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria. Electronic address: birgit.frauscher@i-med.ac.at.
authors: Birgit
authors: B
authors: Frauscher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology*; D015897:Comorbidity; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000503:physiopathology; D004828:Epilepsies, Partial / Q000453:epidemiology / Q000503:physiopathology; D004827:Epilepsy / Q000453:epidemiology* / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Chronotype; Generalized epilepsy; Partial epilepsy; REM sleep behavior disorder; Sleep