Pro-inflammatory diet mediates the association between epilepsy and sleep disorders: A cross-sectional study

Accumulating epidemiological and mechanistic evidence indicates that anti-inflammatory dietary patterns may attenuate systematic inflammation underlying chronic disease, including epilepsy (EP), a common and potentially debilitating neurological disorder frequently complicated by sleep disturbances. Herein, we aim to assess the inflammatory potential of habitual diets among individuals with EP, and co-occurring sleep disorders (SLDs). From 2013 to March 2020, 35,706 participants were enrolled in this study. EP status was defined based on reported use of antiepileptic drugs within the preceding 30 days. SLDs were assessed using questions on habitual sleep duration and validated self-reported sleep disturbances. Dietary inflammatory index (DII) and energy-adjusted DII (E-DII) scores were calculated using 24-h dietary recall data. Individuals with EP exhibited significantly higher DII and E-DII scores and a greater prevalence of SLDs compared with individuals without EP. In the fully adjusted model, participants in Quartile 4 of the DII score had significantly increased odds of EP and SLDs, relative to those in Quartile 1. Mediation analyses revealed that DII accounted for 2.650% to 6.234% of the association between EP and SLDs. In stratified analysis, an elevated prevalence of SLDs was observed across Quartile 2-4 for DII and in Quartile 2 and 4 for E-DII among individuals with EP. Individuals with EP consume diets with greater pro-inflammatory potential than those without EP. SLDs in this population are associated with higher dietary inflammatory burden-highlighting the need for evidence-informed, individualized nutritional guidance as part of comprehensive EP management.