Abstracts

Rationale: Sleep problem is common and an important factor that affects quality of life in people with epilepsy (PWE). There are numerous papers that have described the relationship between epilepsy and sleep. However, there are few studies about sleep hygiene in adults with epilepsy. Therefore, we evaluated in adult epilepsy patients whether sleep hygiene is related to sleep disturbances and quality of life (QoL) independent of depression and anxiety.Methods: This was a cross-sectional, questionnaire-based study. Sleep hygiene was assessed using Sleep Hygiene Index (SHI), which is a 13-item 5-point self-administered index. Higher scores are indicative of more maladaptive sleep hygiene status. Medical Outcome Study (MOS)-Sleep Scale, Epworth Sleepiness Scale, Hospital Anxiety and Depression Scale, Quality of Life in Epilepsy-10 were used. The relations between sleep hygiene and sleep disturbances were performed using the student t test and Pearson correlation analysis. The effect of sleep hygiene on QoL was assessed using multiple linear regression analysis. Variables that showed p-values < 0.1 in the univariate analysis were included in multiple linear regressionResults: In total, 150 adult epilepsy patients participated. The 7.3% to 40.0% of subjects reported they always or frequently had inappropriate sleep hygiene habits on each item of SHI. For example, a quarter of participants reported that they think, plan, or worry when they are in bed, and that they do something that may wake me up before bedtime. Age (r=-0.352, p<0.001) and age at seizure onset (r=-0.272, p=0.001) was negatively related to the scores of SHI. Seizure type and seizure frequency were not related to SHI. PWE who had each insomnia symptom, including difficulties on initiating sleep (p<0.001) and maintaining sleep (p<0.001) and too early awakening (p<0.001), had higher SHI scores. Sleep quality was significantly related to the SHI scores (r=0.466, p<0.001). Daytime sleepiness was not related to sleep hygiene. In multiple linear regression, SHI (ß=-0.312, p<0.001) was identified as a significant factor for predicting lower QoL independent of anxiety (ß =-1.592, p<0.001), depression (ß =-0.951, p=0.008), and antiepileptic drugs polytherapy (ß =-7.262, p<0.001).Conclusions: Sleep hygiene is an important factor contributing to sleep disturbances in PWE and also had a significant impact on their QoL independent of depression, anxiety, and antiepileptic drug treatment.