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Sleep quality and its correlates in people with epilepsy: A multicenter cross-sectional study in Germany

Zöllner JP, Mann C, Willems L, von Podewils F, Langenbruch L, Bierhansl L, Knake S, Menzler K et al.

Epilepsia, 2025

449 participants

Abstract

OBJECTIVE: Sleep disturbances and epilepsy are closely interrelated. This study aimed to examine associations between sleep quality, affective symptoms, and quality of life (QoL) in people with epilepsy (PWE), and to identify clinical and sociodemographic factors linked to impaired sleep.

METHODS: We conducted a multicenter cross-sectional study of adult PWE across four tertiary epilepsy centers in Germany. We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), affective symptoms with the Hospital Anxiety and Depression Scale (HADS), and epilepsy-specific QoL with the 31-item Quality of Life in Epilepsy (QOLIE-31) inventory. We evaluated sociodemographic and clinical predictors of sleep quality and QoL using univariable and multivariable analyses. Comparisons were made with normative data from the general German population and individuals with chronic migraine.

RESULTS: Of 449 individuals (mean age 39.9 years, 58.1% women), 221 (49.2%) were identified as "poor sleepers," significantly exceeding rates in the general population (35.9%, p < .001). In multivariable analysis, poor sleep quality was independently associated with female sex (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.36-3.01, p = .001), unemployment (OR 1.74, 95% CI = 1.10-2.73, p = .017), anxiety (OR = 3.79, 95% CI = 2.39-6.04, p < .001), and depression (OR = 2.19, 95% CI = 1.36-3.54, p = .001). In addition, daily seizures were linked to worse sleep quality (OR = 2.55, 95% CI =…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 449 participants or records.

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