Abstracts

Rationale: Sleep disorders and poor sleep quality have already been described as a consequences of epilepsy. Nevertheless, there are few studies that systematically analyzed circadian rhythm in patients with epilepsy.  This study aimed to evaluate circadian rhythm and sleep quality in patients with drug-resistant and drug-responsive epilepsy in comparison with healthy controls. Methods: This is a cross-sectional and controlled study that evaluated sleep quality and circadian rhythm in three distinct groups: 29 patients (65.5% female; mean age of 37.62 years [SD 11.30]) with drug-resistant epilepsy, 21 patients (57.1% female; mean age of 36.52 years [SD 11.97]) with drug-responsive epilepsy and 35 healthy controls (68.6% female; mean age of 34.69 [SD 10.56]). The evaluation was made through validated questionnaires to assess sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness Scale), circadian rhythm (Morningness-Eveningness Questionnaire). Due to the importance of depressive and anxiety symptoms in sleep, we also evaluated depressive (Beck Depression Inventory II-BDI) and anxious symptoms (State and Trait Anxiety Inventory-STAI). The three groups did not differ considering age (p 0.586), gender distribution (p 0.683) and STAI scores (p 0.851). Patients with drug-resistant epilepsy had higher scores in BDI (p 0.008) (Table 1). Statistical analysis was performed using one-way analysis of covariance with BDI scores as a covariate. Results: Patients with epilepsy – drug-resistant and drug-responsive - had worse scores in Epworth Sleepiness Scale (p 0.036), and Morningness-Eveningness Questionnaire (p 0.026) compared to controls . No difference was observed in Pittsburgh Sleep Quality Index. After covariation for BDI scores, patients with epilepsy (p 0.019) and patients with drug-resistant epilepsy (p 0.012) had lower scores in the Morningness-Eveningness Inventory compared to controls , but not in others. (Table 2) Conclusions: In this study, we observed that patients with drug-responsive and drug-resistant epilepsy differ from controls in sleep quality, but in daytime sleepiness and circadian phenotype. Our findings showed that depressive symptoms play a major role in the presence of daytime sleepiness in patients with epilepsy. Patients with drug-resistant epilepsy presented a tendency to be more evening-oriented inside the intermediate group of circadian phenotype. The authors believe that several epilepsy variables and social factors may determine this evening orientation. Funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)