title: Sleep hygiene and its association with mood and quality of life in people with epilepsy.
abstract: OBJECTIVE
  We determined whether sleep hygiene is directly related to mood and quality of life (QoL) in people with epilepsy and, if not, documented the indirect effects of sleep hygiene through sleep quality.
  
  
  METHODS
  Data were collected from 150 adults with epilepsy. The Sleep Hygiene Index (SHI), Quality of Life in Epilepsy-10 (QOLIE-10), Hospital Anxiety and Depression Scale (HADS), Sleep Problems Index-2 (SPI-2) of the Medical Outcomes Study-Sleep Scale, and Epworth Sleepiness Scale (ESS) were used. To determine the direct and indirect associations between SHI, mood, and QoL, multiple linear regression analyses and the Sobel test were performed.
  
  
  RESULTS
  Inadequate sleep hygiene behaviors were answered affirmatively by ≥15% of the participants represented by 6 out of 13 items of the SHI. A younger age was independently related to higher SHI scores (p=0.013). The higher SHI scores were directly related to lower QoL independent of sleep quality, anxiety, and depressive symptoms (p<0.05) but not independently related to anxiety and depressive symptoms. The Sobel test confirmed that the SHI scores were associated with anxiety and depressive symptoms through sleep quality (p<0.001).
  
  
  CONCLUSIONS
  Inadequate sleep hygiene is independently related to low QoL but indirectly related to anxiety and depressive symptoms through sleep quality. Patients of a younger age are at risk of poorer sleep hygiene.
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: salee@amc.seoul.kr.
authors.forename: Sang-Ahm
authors.initials: SA
authors.lastname: Lee
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Su-Hyun
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: No
authors.affiliation: Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
authors.forename: Kwang-Deog
authors.initials: KD
authors.lastname: Jo
authors.affiliation: Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
authors.forename: Jee-Hyun
authors.initials: JH
authors.lastname: Kwon
authors.affiliation: Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Shin
mesh_terms: D000328:Adult; D000339:Affect; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004827:Epilepsy / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D056910:Republic of Korea; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D055815:Young Adult
keywords: Anxiety; Daytime sleepiness; Depression; Epilepsy; Quality of life; Sleep disturbance; Sleep hygiene; Sleep quality