Ying Xu1, Maree L Hackett2, Armin Nikpour3, Ernest Somerville4, Andrew Bleasel5, Carol Ireland6, Daniel F Ghougassian7, Craig S Anderson8, Nick Glozier9. 1. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, 83-117 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, University of Sydney, Sydney, Australia. Electronic address: y.xu@neura.edu.au. 2. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, 83-117 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, University of Sydney, Sydney, Australia; Faculty of Health and Wellbeing, University of Central Lancashire, Preston PR1 2HE, United Kingdom. Electronic address: mhackett@georgeinstitute.org.au. 3. Sydney Medical School, University of Sydney, Sydney, Australia; Neurology Department, Royal Prince Alfred Hospital, Sydney Local Area Health District, Camperdown, NSW 2050, Australia. Electronic address: armin@sydneyneurology.com.au. 4. Neurology Department, Prince of Wales Clinical School, University of New South Wales, Barker St, Randwick, NSW 2031, Australia. Electronic address: e.somerville@unsw.edu.au. 5. Neurology Department, Westmead Hospital, Cnr Hawkesbury Road and Darcy Road, Westmead, NSW 2145, Australia. Electronic address: andrew.bleasel@sydney.edu.au. 6. Epilepsy Action Australia, PO Box 879, Epping, NSW 1710, Australia. Electronic address: CIreland@epilepsy.org.au. 7. Neurology Department, Prince of Wales Clinical School, University of New South Wales, Barker St, Randwick, NSW 2031, Australia. Electronic address: Daniel@Nareg.Com.AU. 8. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, 83-117 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, University of Sydney, Sydney, Australia; Neurology Department, Royal Prince Alfred Hospital, Sydney Local Area Health District, Camperdown, NSW 2050, Australia; The George Institute for Global Health at Peking University Health Science Centre, Level 18, Tower B, Horizon Tower, No. 6 Zhichun Rd, Haidian District, Beijing, 100088, PR China. Electronic address: canderson@georgeinstitute.org.au. 9. Brain and Mind Centre, University of Sydney, 94 Mallett St, Camperdown, NSW 2050, Australia. Electronic address: nick.glozier@sydney.edu.au.
Abstract
OBJECTIVE: To determine the course of sleep distrurbance (insomnia symptoms and short sleep duration) after a diagnosis of epilepsy and their associations with seizure control, mood, disability, and quality of life. PATIENTS AND METHODS: One hundred and sixty-nine adults were drawn from the Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC), a prospective, multicenter, community-wide study in Sydney, Australia. Socio-demographic, psychosocial, clinical characteristics, and information on sleep disturbance were obtained early (median 48 [IQR15-113] days) after a diagnosis of epilepsy, and at 12 months. Logistic regression models were used to determine associations between patterns of sleep disturbance with outcomes at 12 months. RESULTS: Insomnia symptoms and/or short sleep duration were present in 18-23% of participants at both time points, with over half (54-61%) showing a chronic pattern. There was no association of sleep disturbance pattern with recurrent seizures, medication use or disability. Chronic insomnia symptoms and short sleep duration were strongly associated with worse mental health (aOR 3.76, 95% CI 1.28-11.06; and aOR 5.41, 95% CI 1.86-15.79) and poorer quality of life at 12 months (aOR 3.02, 95% CI 1.03-8.84; and aOR 3.11, 95% CI 1.10-8.82), after adjusting for clinical features of epilepsy and comorbidity. Those whose sleep disturbance remitted had no adverse outcomes. CONCLUSIONS: Insomnia symptoms and short sleep duration are less common in people with recently-diagnosed than chronic epilepsy. The temporal association with poor psycholosocial outcomes supports specific interventions addressing sleep disturbance.
OBJECTIVE: To determine the course of sleep distrurbance (insomnia symptoms and short sleep duration) after a diagnosis of epilepsy and their associations with seizure control, mood, disability, and quality of life. PATIENTS AND METHODS: One hundred and sixty-nine adults were drawn from the Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC), a prospective, multicenter, community-wide study in Sydney, Australia. Socio-demographic, psychosocial, clinical characteristics, and information on sleep disturbance were obtained early (median 48 [IQR15-113] days) after a diagnosis of epilepsy, and at 12 months. Logistic regression models were used to determine associations between patterns of sleep disturbance with outcomes at 12 months. RESULTS:Insomnia symptoms and/or short sleep duration were present in 18-23% of participants at both time points, with over half (54-61%) showing a chronic pattern. There was no association of sleep disturbance pattern with recurrent seizures, medication use or disability. Chronic insomnia symptoms and short sleep duration were strongly associated with worse mental health (aOR 3.76, 95% CI 1.28-11.06; and aOR 5.41, 95% CI 1.86-15.79) and poorer quality of life at 12 months (aOR 3.02, 95% CI 1.03-8.84; and aOR 3.11, 95% CI 1.10-8.82), after adjusting for clinical features of epilepsy and comorbidity. Those whose sleep disturbance remitted had no adverse outcomes. CONCLUSIONS:Insomnia symptoms and short sleep duration are less common in people with recently-diagnosed than chronic epilepsy. The temporal association with poor psycholosocial outcomes supports specific interventions addressing sleep disturbance.