Excessive daytime sleepiness in patients with epilepsy: a subjective evaluation

The main objective of the study was to evaluate excessive daytime sleepiness (EDS) in patients with epilepsy from a tertiary outpatient clinic in Rio de Janeiro, Brazil.

Ninety-nine unselected patients from the epilepsy outpatient clinic were invited and their sleep-wake habits were assessed by means of a clinical interview and four validated instruments: Epworth Sleepiness Scale, Beck Depression Inventory, Beck Anxiety Inventory, and the Basic Nordic Sleep Questionnaire. Sociodemographic information and characteristics of the epilepsy syndrome were collected.

Complaints about EDS (Epworth Sleepiness Scale score >10) were reported by 47.5% (95% CI: 37.3-57.7) of the patients. In the sample, 52.6% (95% CI: 0.41-0.60) were overweight or obese, and 53.1% (95% CI: 0.43-0.62) had less than 8 years of formal education. Mainly anxiety, but also neck circumference, was correlated with EDS. Our patients did not exhibit quantitative sleep deprivation. No other epilepsy-related variable showed relationship with EDS. The prevalence of EDS in our population was higher than in similar studies performed in other countries. This finding does not seem to be related to epilepsy itself, but rather to other clinical factors, such as neck circumference, and mainly psychiatric factors, such as anxiety.

Psychiatric comorbidities such as anxiety are linked to EDS and should be recognized and treated. More studies based on objective sleep quality analysis are needed to help elucidate these relationships in the Brazilian population.