Sleep and Mood Disorders and Related Factors in Patients with Epilepsy

Abstract

Introduction: Subjective sleep disorders and psychiatric comorbidities are more common in patients with epilepsy than in the general population, and this negatively affects quality of life. In this study, we aimed to determine sleep and mood disorders and related factors in epilepsy patients. Method: Seventy-five patients who had been followed up in the epilepsy outpatient clinic of Adana City Training and Research Hospital for at least two years with a diagnosis of epilepsy according to the International League Against Epilepsy diagnostic criteria were included in the study. Demographic data, seizure type, seizure frequency, duration of the disease, number of medications used, history of status epilepticus, and the occurrence of seizures during sleep and wakefulness were recorded. The presence of restless legs syndrome was questioned according to the International Restless Legs Syndrome Study Group criteria. Pittsburgh sleep quality index, Epworth sleepiness scale, Beck depression inventory and Beck anxiety scale were administered. Informed consent form was obtained from all patients. Results: Of the 75 patients included in the study, 43 (57.3%) were female and 32 (42.7%) were male, with a mean age of 33±13.9 years and a mean disease duration of 12.9±11.2 years. Seizures occurred during sleep in 36 (48%) and during wakefulness in 66 (88%) patients. Restless legs syndrome was noted in 25 (33.3%) patients. Those with a history of nocturnal and frequent seizures and restless legs syndrome findings had poor sleep quality and long-term sleep disturbance (p<0.05). There was a positive correlation between Beck depression scale score and restless legs syndrome. In addition, anxiety level was found to be high in the presence of restless legs syndrome and in patients with generalized onset seizures (p<0.05). Conclusion: Our study showed that poor sleep quality may be associated with the presence of seizures, seizure frequency, anxiety and depression symptoms in epilepsy patients. In addition, it was found that the presence of restless legs syndrome findings may contribute negatively to this. A better quality of life should be among our treatment goals in epilepsy patients and sleep quality should be improved with effective seizure control and appropriate treatment alternatives.

Keywords

• epilepsy
• restless leg syndrome
• sleep
• mood disorders

Epilepsili Hastalarda Uyku ve Duygudurum Bozuklukları ve İlişkili Faktörler

Abstract

Giriş: Epilepsi hastalarında subjektif uyku bozuklukları ve psikiyatrik komorbiditeler genel popülasyona göre daha fazla görülmektedir ve bu durum yaşam kalitesini olumsuz yönde etkilemektedir. Bu çalışmada epilepsi hastalarında uyku ve duygu durum bozuklukları ve ilişkili faktörleri belirlemeyi amaçladık. Yöntem: Adana Şehir Eğitim ve Araştırma Hastanesi Epilepsi polikliniğinde Uluslararası Epilepsi ile Savaş Ligi tanı kriterlerine göre epilepsi tanısı ile en az iki yıldır takip edilen 75 hasta çalışmaya dahil edildi. Hastaların demografik verileri, nöbet tipi, nöbet sıklığı, hastalık süresi, kullandığı ilaç sayısı, status epileptikus öyküsü, nöbetlerin uykuda ve uyanıklıkta olma durumları kaydedildi. Huzursuz bacaklar sendromu varlığı Uluslararası Huzursuz Bacaklar Sendromu çalışma grubu kriterlerine göre sorgulandı. Hastalara Pittsburgh uyku kalitesi indeksi, Epworth uykululuk ölçeği, Beck depresyon envanteri ve Beck anksiyete ölçeği uygulandı. Tüm hastalardan bilgilendirilmiş onam formu alındı. Bulgular: Çalışmaya dahil edilen 75 hastanın; 43’ü (%57,3) kadın, 32’si (%42.7) erkek olup, yaş ortalamaları 33±13.9 ve hastalık süreleri ortalama 12.9±11.2 idi. Hastaların 36’sında (%48) nöbetler uykuda, 66’sında ise (%88) uyanıklıkta idi. 25 (%33,3) hastada huzursuz bacaklar sendromu kaydedildi. Nokturnal ve sık nöbet öyküsü ile huzursuz bacaklar sendromu bulguları olanların kötü uyku kalitesi ve uzun dönem uyku bozukluğu mevcuttu(p<0.05). Hastaların Beck depresyon ölçeği puanı ile huzursuz bacaklar sendromu arasında pozitif korelasyon saptandı. Ayrıca huzursuz bacaklar sendromu varlığında ve jeneralize başlangıçlı nöbetleri olan hastalarda kaygı düzeyi yüksek olarak bulundu(p<0.05). Sonuç: Çalışmamız epilepsi hastalarında; kötü uyku kalitesinin uykuda nöbet varlığı, nöbet sıklığı, anksiyete ve depresyon semptomlarıyla ilişkili olabileceğini göstermiştir. Ek olarak huzursuz bacaklar sendromu bulguları varlığının buna olumsuz katkıda bulunabileceği saptanmıştır. Epilepsi hastalarında, daha iyi bir yaşam kalitesi tedavi hedeflerimiz arasında olmalı ve bu hastalarda etkin nöbet kontrolü ve uygun tedavi alternatifleriyle uyku kalitesinin artırılması sağlanmalıdır.

Keywords

• epilepsi
• huzursuz bacaklar sendromu
• uyku
• duygu durum bozuklukları

Supporting Institution

Yazarlar bu çalışma için finansal destek ve bağış almadıklarını beyan etmişlerdir.

Ethical Statement

Çalışma için Adana Şehir Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu 07/12/2023 tarih ve 2984-141 Karar no ile onay alınmıştır.

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