Abstracts

Sleep disturbances are common in epilepsy, resulting from seizures, antiepileptic medications, and coexisting sleep disorders. This study reports sleep disturbances among patients (pts) taking stable regimens of at least two antiepileptic drugs (AEDs) and evaluates the impact of sleep problems on health-related quality of life (HRQOL). We surveyed 201 partial-onset epilepsy adult pts receiving [ge] 2 AEDs for [ge] 60 days. Pts were recruited from community-based neurologists in the US. Neurologists recorded patient demographic and clinical information. Pts completed questionnaires including the Medical Outcomes Study (MOS) Sleep Scale, the Quality of Life in Epilepsy-10 survey (QOLIE -10), and the EuroQoL-5D survey (EQ-5D). The 9-item MOS Sleep Problems Index, derived from the MOS-Sleep Scale, provides a broad summary of sleep problems (e.g., getting to sleep, staying asleep, daytime sleepiness, feelings of being rested). Scores on the 9-item Index range from 0 to 100; higher scores indicate greater sleep problems. Conversely, higher QOLIE-10 (range: 0[ndash]100) and EQ-5D (range: -0.6[ndash]1.0) scale scores indicate better HRQOL. We correlated sleep outcomes with HRQOL and with clinical and demographic characteristics using correlation coefficients and analysis of variance models. The mean (sd) age of pts was 44.2 (12.5). 56% were female, and 86% were white. Neurologists reported that 34% of pts had been diagnosed with sleep disturbances, and 10% had been prescribed sleep medications, usually benzodiazepines. Pts diagnosed with a sleep disturbance reported poorer mean QOLIE-10 (55.2 vs 63.7; p=0.006) and EQ-5D (0.5 vs 0.7; p[lt]0.001) scores relative to those without sleep disturbances. The mean (sd) MOS Sleep score in the overall sample was 36.2 (20.8), above the general population mean of 26. Women reported more sleep problems than men (42.3 vs 28.4; p[lt]0.001). Pts with physician-reported anxiety or depression had more sleep problems than those without these comorbidities (anxiety: 44.5 vs 33.1; p[lt]0.001; depression: 41.2 vs 32.8; p=0.005). Higher MOS Sleep Problems scores were significantly correlated with poorer QOLIE-10 (r = -0.49; p[lt]0.001) and EQ-5D (r = -0.56; p[lt]0.001) scores. Pts experiencing a seizure within one week reported higher MOS Sleep Problem scores than those with a less recent seizure (41.5 vs 32.8; p=0.003). Pts with partial-onset epilepsy on stable polytherapy regimens experience more sleep problems than the general population, with women reporting more problems than men. Diagnosed and self-reported sleep disturbances are negatively associated with pts[rsquo] daily functioning and well-being. The nature of these disturbances could not be determined by this study, however recognition and treatment of sleep problems clearly represent an opportunity to better the care of epilepsy pts. (Supported by Pfizer, Inc.)