title: Associations of impaired sleep quality, insomnia, and sleepiness with epilepsy: A questionnaire-based case-control study.
abstract: OBJECTIVE
  The purpose of this study was to document the frequency of sleep problems including poor sleep quality, excessive daytime sleepiness, and insomnia in subjects with epilepsy compared with healthy controls and to determine the factors associated with these sleep disturbances.
  
  
  METHODS
  We recruited 180 patients with epilepsy (age: 43.2 ± 15.6 years, men: 50.0%) and 2836 healthy subjects (age: 44.5 ± 15.0 years, men: 49.8%). Sleep and the anxiety/mood profiles were measured using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Goldberg Anxiety Scale, and Patient Health Questionnaire-9 depression scale. Associations of sleep problems with epilepsy and other factors were tested by multiple logistic regression analysis, adjusted for age, gender, body mass index, alcohol intake, smoking, perceived sleep insufficiency, and habitual snoring.
  
  
  RESULTS
  Sleep disturbances were more common in the group with epilepsy than in the controls (53.3% vs. 25.5%; p<0.001). Poor sleep quality, excessive daytime sleepiness, and insomnia were significantly associated with epilepsy (odds ratio [95% confidence interval]: 3.52 [2.45-5.05], 2.10 [1.41-3.12], 5.91 [3.43-10.16], respectively). Depressive mood, anxiety, and perceived sleep insufficiency contributed to the presence of sleep disturbances. In the group with epilepsy, seizure remission for the past year related to a lower frequency of insomnia, whereas age, sex, type of epilepsy, and number of antiepileptic drugs were not correlated with sleep problems.
  
  
  CONCLUSIONS
  Epilepsy was significantly associated with the higher frequency of sleep disturbances, which supports the importance of screening sleep problems in patients with epilepsy and providing available intervention.
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: coolere@naver.com.
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Im
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: nrpsh@snu.ac.kr.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: wysiwyg2@naver.com.
authors.forename: Shin-Hye
authors.initials: SH
authors.lastname: Baek
authors.affiliation: Department of Neurology, Hallym University College of Medicine, Anyang, Republic of Korea. Electronic address: chuminkyung@gmail.com.
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Chu
authors.affiliation: Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea. Electronic address: kiyang@sch.ac.kr.
authors.forename: Kwang Ik
authors.initials: KI
authors.lastname: Yang
authors.affiliation: Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: kzoo@yuhs.ac.
authors.forename: Won-Joo
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: ych333@gmail.com.
authors.forename: Chang-Ho
authors.initials: CH
authors.lastname: Yun
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D001007:Anxiety / Q000150:complications; D001008:Anxiety Disorders / Q000150:complications; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D012894:Sleep Stages / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Quality of life; Seizure; Sleep disturbance