Poor sleep quality was reported in 70% of epilepsy patients and was associated with increased insomnia severity, excessive daytime sleepiness, and psychiatric comorbidities, while generalized tonic-clonic seizures in the past year and specific antiepileptic drug concentrations were significantly linked to sleep outcomes.
Poor sleep quality was highly prevalent in adults with epilepsy, affecting 70.9% of the study sample.
Patients who experienced generalized tonic-clonic seizures (GTCS) in the past year had significantly worse sleep quality than those without GTCS.
Clinical insomnia was present in nearly one quarter of patients and was significantly associated with the presence of seizures.
Excessive daytime sleepiness (EDS) was present in 19% of patients and was associated with depressive symptoms.
Levetiracetam concentration was associated with better sleep quality, while higher lamotrigine concentration was associated with worse sleep quality.
EEG abnormalities, seizure frequency, and duration of epilepsy were not associated with sleep quality.
Psychiatric comorbidities including depression and anxiety were significantly associated with poor sleep quality in patients with epilepsy.
This research suggests that sleep problems are extremely common among people with epilepsy. In a study of 78 adults with epilepsy, more than 70% reported poor sleep quality, about 23% had significant clinical insomnia, and roughly 1 in 5 experienced excessive daytime sleepiness. These sleep problems were closely linked to symptoms of depression and anxiety, suggesting that mental health and sleep difficulties often go hand-in-hand in this population. The research also found that specific seizure types mattered for sleep health. Patients who had experienced generalized tonic-clonic seizures (the type often described as 'grand mal' seizures involving full-body convulsions) within the past year slept significantly worse than those who had not. People who were seizure-free tended to have less insomnia. Interestingly, the type of anti-epileptic medication and its blood concentration also appeared to matter — higher levels of levetiracetam were linked to better sleep, while higher levels of lamotrigine were linked to worse sleep. Notably, factors like how long someone had had epilepsy, EEG brain wave abnormalities, and general seizure frequency were not associated with sleep quality. These findings highlight that sleep problems in epilepsy are not simply a side effect of having the condition for a long time, but are tied to active seizure activity, specific medications, and mental health. This research suggests that clinicians caring for people with epilepsy should routinely screen for sleep disturbances, insomnia, and daytime sleepiness, and consider psychiatric comorbidities and medication choices as important factors in managing overall quality of life for these patients.
Bartašiūnaitė S, Burkojus D, Šmigelskytė A, Jurkevičienė G, Gelžinienė G. (2026). Sleep Quality in Patients with Epilepsy: Differences in Anxiety, Depression, and Clinical Characteristics.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62020403