Abstracts

Sleep disturbances may be more common in epilepsy patients, potentially resulting in decreased memory, attention, and alertness as well as increased seizures. However, sleep problems are frequently overlooked, and the actual prevalence of sleep problems (in general and in epilepsy) is not well understood. This prospective study looked at sleep problems in an epilepsy referral center using a standardized questionairre, and compared scores with subjects accompanying epilepsy patients who did not have epilepsy., All patients with epilepsy (PWE) seen as inpatients or outpatients at an epilepsy referral center were invited to participate. Questionnaires included basic demographic information, the MOS sleep scale, and questions about sleep hygiene. Companions without epilepsy were also surveyed as controls. PWE had seizure diagnosis verified by treating physicians. The study was approved by the institutional review board., 187 surveys were returned. Average age was 45 years for PWE, 47 years for controls. 50% of PWE were women compared with 62% of controls. Nearly all PWE were being treated with anticonvulsant drugs. PWE scored significantly higher on the sleep adequacy subscale of the MOS sleep scale, reflecting worse sleep (53 +/- 2 vs. 43 +/- 3). There were no significant differences in subscales measuring sleep somnolence, optimal sleep, awakening short of breath, or overall sleep problems index although subjects with epilepsy scored worse in all of these. Subjects with epilepsy more commonly reported signs of insomnia (43% vs 34%), restless legs syndrome/periodic limb movements (37% vs 25%), and sleep apnea (43% vs 34%) than control subjects, but controls more commonly reports excessive daytime sleepiness (46% for control vs 37% for PWE). None of these differences were statistically significant. PWE slept significantly longer than controls during the week (6.9 +/- 0.1 vs. 6.2 +/- .22 hrs) but not on weekends. Subjects in both groups had signs of poor sleep hygiene, particularly including use of alcohol shortly before bedtime., In this relatively small sample, sleep adequacy was more impaired in epilepsy patients than in their companions without epilepsy. Other measures suggested increased sleep problems in PWE but did not reach statistical significance. It may be that, with a larger sample, differences between these two groups can be clarified. More objective evaluations, including evaluation by sleep specialists and polysomnography would be needed to idenify the actual frequency of specific sleep disorders. PWE slept longer on average; it was not clear whether this was due to medication, employment status, or other factors. Both groups had signs of poor sleep hygiene, suggesting the need for education regarding sleep in PWE and in the general population.,