Heart rate variability, quality of life, and sleep quality in patients with epilepsy

Recent data have shown that patients with epilepsy experience reduced quality of life and poor sleep quality, which are also closely related to heart rate variability. For the first time, we investigated the relationship between heart rate variability and quality of life and sleep in patients with epilepsy.

Twenty-seven patients with medically controlled epilepsy, 23 patients with drug-resistant epilepsy, and 36 healthy subjects were included in this cross-sectional prospective study. Heart rate variability analysis was conducted using a 24-h rhythm Holter device in all cases. The quality of life in epilepsy-31 questionnaire and Pittsburgh Sleep Quality Index questionnaire were used for patients with epilepsy.

Compared to the control group, patients with epilepsy had lower heart rate variability parameters, including standard deviation of normal-to-normal, standard deviation of normal-to-normal index, standard deviation of the averages of the normal-to-normal, root mean square of successive differences, and percentage of NN Intervals >50 ms (pNN50) values (p<0.001). Heart rate variability parameters and sleep scores were similar between the drug-resistant epilepsy and medically controlled epilepsy subgroups (p>0.05). In addition, quality of life in epilepsy-31 subscores were significantly lower in drug-resistant epilepsy than in medically controlled epilepsy in the subdomains of seizure worry (p=0.001), overall quality of life (p=0.004), emotional well-being (p=0.005), and cognitive functioning (p=0.007). There was a significant positive correlation between standard deviation of the averages of the normal-to-normal and cognition (r=0.335; p=0.017); maximum QT and emotional well-being (r=0.286; p=0.046); and maximum QTc and emotional well-being (r=0.292; p=0.042) in patients with epilepsy.

We found that low heart rate variability was more common in patients with epilepsy. Quality of life was also highly impaired in drug-resistant epilepsy, and low heart rate variability correlated with low cognition and emotional well-being in patients with epilepsy.