Abstracts

Rationale: Patients with epilepsy often have sleep problems including insomnia and excessive daytime sleepiness (EDS). Chronotype has attracted attention as a factor associated with sleep problems. Many questionnaire studies reported sleep problems and chronotype in patients with epilepsy. However, any differences in these issues in each epilepsy classification remain unclear. The present study investigated sleep problems and chronotype in each epilepsy classification in patient with epilepsy who underwent comprehensive evaluation. Whether the number of antiepileptic drugs (AEDs) affects these parameters was also examined. Methods: The present study included 159 patients with epilepsy (100 men, aged 19-50 years), who admitted to our epilepsy monitoring unit. Thirty of 159 patients were diagnosed as idiopathic generalized epilepsy (IGE), 62 temporal lobe epilepsy (TLE), 23 frontal lobe epilepsy (FLE), and 44 other focal epilepsy. Twenty-eight patients with non-epilepsy (NE) (14 men, aged 19-49 years) were also recruited. EDS, sleep quality, and chronotype were evaluated with Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI), and Morningness-Eveningness Questionnaire (MEQ), respectively. The patients with epilepsy were classified into no AED use, monotherapy, and polytherapy groups based on the number of AEDs, and the relationship between the classification and each questionnaire score was examined. Results: Patients with EDS (11 or more out of 24 ESS score) were significantly more common in IGE (60%) than in TLE, FLE, other focal epilepsy, and NE (29 to 46%) (p < 0.01 or 0.05). Patients with poor sleep quality (6 or more out 21 PSQI score) were significantly more common in IGE (50%) than in TLE (34%) (p < 0.05), but not than in NE (46%). Patients with evening-oriented chronotype (41 or less out of 86 MEQ score) were significantly more common in IGE (33%) than in TLE, other focal epilepsy, and NE (8 to 21%) (p < 0.01 or 0.05). Patients with TLE, FLE, and other focal epilepsy showed no significant differences in ESS, PSQI, and MEQ compared to NE. No significant association was found between the number of AEDs and each questionnaire score in any groups. Conclusions: The retrospective review of patients who were diagnosed by comprehensive evaluation shows that patients with IGE are likely to show EDS and evening-oriented chronotype. Patient with focal epilepsy showed no differences in sleep problems and chronotype compared to NE. The number of AEDs does not affect sleep problems and chronotype. Funding: No funding