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Research ArticleOriginal Article
Open Access

Sleep quality, daytime sleepiness, and insomnia in patient with epilepsy: A single center experience from Saudi Arabia

Asmaa A. Alenizi, Alaa M. Eskandrani, Safiyyah A. Asiri, Fawaiyzah A. Ba Maqdom, Majed H. Al Hameed, Rayan A. Al Harbi, Moneera O. Aldraihem and Mubarak M. Aldosari
Neurosciences Journal January 2023, 28 (1) 19-26; DOI: https://doi.org/10.17712/nsj.2023.1.20220062
Asmaa A. Alenizi
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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  • For correspondence: [email protected]
Alaa M. Eskandrani
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Safiyyah A. Asiri
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Fawaiyzah A. Ba Maqdom
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Majed H. Al Hameed
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Rayan A. Al Harbi
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Moneera O. Aldraihem
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Mubarak M. Aldosari
From Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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Article Figures & Data

Figures

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  • Figure 1
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    Figure 1

    - Prevalence of poor sleep quality among patients with epilepsy using PSQI.

  • Figure 2
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    Figure 2

    - Epilepsy awareness score distribution among participants.

Tables

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    Table 1

    - Socio-demographic and clinical characteristics of patients with epilepsy (n =218).

    CharacteristicsTotal
    n(%)
    Age (years)
    18 to 2794(43.1)
    28 to 3887(39.9)
    39 to 4925(11.5)
    50 to 6012(5.5)
    Gender
    Female113(51.8)
    Male105(48.2)
    Education
    No education or primary18(8.3)
    Intermediate15(6.9)
    Secondary69(31.7)
    University or post university116(53.2)
    Marital status
    Single120(55)
    Married92(42.2)
    Separated/divorced6(2.8)
    Employment status
    Employed64(29.4)
    Retired7(3.2)
    Unemployed95(43.6)
    Student52(23.9)
    Comorbidity
    None212(97.2)
    Some type of comorbidity6(2.8)
    • View popup
    Table 2

    - Clinical characteristics of patients with epilepsy.

    Clinical characteristicsTotal
    n(%)
    Type of epilepsy
    Focal130(59.6)
    Generalized80(36.7)
    Both8(3.7)
    Onset of epilepsy
    Infancy18(8.3)
    Childhood65(29.8)
    Adolescent43(19.7)
    Adulthood92(42.2)
    Timing of seizure
    Predominantly nocturnal151(15)
    Predominantly daytime566(56.2)
    Both291(28.9)
    Frequency of seizure
    Annually79(36.2)
    Monthly89(40.8)
    Weekly25(11.5)
    Daily15(6.9)
    Long time ago or once10(4.6)
    Cause of epilepsy
    Genetic77(35.3)
    Structural105(48.2)
    Metabolic/infectious/non-lesional18(8.3)
    Under investigation18(8.3)
    ASMs
    Monotherapy84(38.5)
    Polytherapy134(61.5)
    Drug response
    Drug responsive90(41.3)
    Drug resistant117(53.7
    NA/not fitting11(5)
    The proactive factor for seizure
    Lack of sleep47(21.6)
    Stress33(15.1)
    Non-compliance to ASMs51(23.4)
    No specific reason66(30.3)
    More than one factor21(9.6)
    Brain MRI
    Normal87(39.9)
    Abnormal110(50.5)
    Not available/not done21(9.6)

    ASMs=antiseizure medications; MRI=magnetic resonance imaging

      • View popup
      Table 3

      - Sleep quality in relation to daytime sleepiness and insomnia.

      CharacteristicsTotalSleep qualityP-ValueCrude OR95% CI
      GoodPoor
      n(%)n(%)n(%)
      ISI interpretation
      No insomnia92(42.2)44(80)48(29.4)<0.00011
      Subthreshold insomnia82(37.6)10(18.2)72(44.2)6.603.0314.37
      Clinical insomnia44(20.2)1(1.8)43(26.4)39.425.21298.44
      ESS interpretation
      Normal140(64.2)45(81.8)95(58.3)0.0021
      Average amount of DTS39(17.9)8(14.5)31(19)1.840.784.31
      May or should consider seek medical attention39(17.9)2(3.6)37(22.7)8.762.0237.98

      CI = confidence interval; DTS-daytime sleepiness; ESS-Epworth Sleepiness Scale; ISI-Insomnia Severity Index; OR-odds ratio.

        • View popup
        Table 4

        - Correlations among sleep quality, daytime sleepiness, and insomnia (n = 218).

        CharacteristicsPSQI total scoreESS scoreISI score
        PSQI total score
        Pearson Correlation1.329**.654**
        Sig. (2-tailed).000.000
        ESS score
        Pearson Correlation.329**1.407**
        Sig. (2-tailed).000.000
        ISI score
        Pearson Correlation.654**.407**1
        Sig. (2-tailed).000.000
        • ↵Notes: ** Correlation is significant at p<.001, ESS-Epworth Sleepiness Scale; ISI-Insomnia Severity Scale; PSQI-Pittsburgh Sleep Quality Index

        • View popup
        Table 5

        - Risk factors of poor sleep quality among patients with epilepsy.

        Age (years)AOR95% CI
        18 to 271
        28 to 381.3530.5233.504
        39 to 490.4970.1172.102
        50 to 605.7150.80840.443
        Employment status
        Employed1
        Retired0.370.035.07
        Unemployed0.630.251.59
        Student1.030.293.60
        Onset of epilepsy
        Infancy1
        Childhood3.470.8114.94
        Adolescent0.820.193.56
        Adulthood1.880.477.50
        Frequency of seizure
        Annually1.00
        Monthly2.511.006.25
        Weekly2.050.537.86
        Daily2.270.3415.29
        A long time ago or once2.530.3518.27
        ASMs
        Monotherapy1
        Polytherapy0.640.281.49
        Brain MRI
        Normal1
        Abnormal0.640.281.48
        Not available /not done1.670.466.08
        ISI interpretation
        No insomnia1
        Subthreshold insomnia0.940.312.84
        Clinical insomnia5.451.0229.14
        ESS interpretation
        Normal1
        The average amount of DTS6.8372.77916.822
        May or should consider medical attention44.1495.184375.977

        ASMs-antiseizure medications, AOR-adjusted odds ratio, CI-confidence interval, DTS-daytime sleepiness, ESS-Epworth Sleepiness Scale, ISI-Insomnia Severity Index, MRI-magnetic resonance imaging

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        Sleep quality, daytime sleepiness, and insomnia in patient with epilepsy: A single center experience from Saudi Arabia
        Asmaa A. Alenizi, Alaa M. Eskandrani, Safiyyah A. Asiri, Fawaiyzah A. Ba Maqdom, Majed H. Al Hameed, Rayan A. Al Harbi, Moneera O. Aldraihem, Mubarak M. Aldosari
        Neurosciences Journal Jan 2023, 28 (1) 19-26; DOI: 10.17712/nsj.2023.1.20220062

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        Sleep quality, daytime sleepiness, and insomnia in patient with epilepsy: A single center experience from Saudi Arabia
        Asmaa A. Alenizi, Alaa M. Eskandrani, Safiyyah A. Asiri, Fawaiyzah A. Ba Maqdom, Majed H. Al Hameed, Rayan A. Al Harbi, Moneera O. Aldraihem, Mubarak M. Aldosari
        Neurosciences Journal Jan 2023, 28 (1) 19-26; DOI: 10.17712/nsj.2023.1.20220062
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