Abstracts

Rationale: To determine the prevalence and clinical associations of insomnia in patients with epilepsy and to determine associations with mood and quality of life.Methods: Consecutive patients with epilepsy attending clinical visits were surveyed with the Insomnia Severity Index (ISI), demographic and epilepsy data, sleep-wake habits, sleepiness (Epworth Sleepiness Scale (ESS), the Hörne-Östberg Morningness-Eveningness Questionnaire (MEQ), mood (Center for Epidemiologic Studies Depression Scale, CES-D), and quality of life (QOLIE-P-10). Patients had to be treated with at least one anticonvulsant. Patients with known psychogenic pseudoseizure were excluded.Results: 207 patients completed surveys. 43% had significant insomnia, and 51% had at least mild insomnia. Younger age and shorter duration of epilepsy were associated with more severe insomnia. Patients with seizures in the most current month had worse insomnia than those without seizures. Those using sedative-hypnotics had worse insomnia. Patients with one or more unexpected health care visits had worse insomnia. Delayed sleep phase, preference of a delayed sleep phase, worse mood, and worse quality of life all correlated with worse insomnia scores.Conclusions: Insomnia is common in epilepsy, has strong associations with poor seizure control, health care utilization, circadian delay, and depression, and correlates with poor quality of life. Assessment and treatment of insomnia may be important in the comprehensive care of epilepsy.