Steep-wake habits and disorders in a series of 100 adult epilepsy patients - A prospective study

The aim of the study was to assess steep-wake habits and disorders and excessive daytime sleepiness (EDS) in an unsetected outpatient epilepsy population. Steep-wake habits and presence of steep disorders were assessed by means of a clinical interview and a standard questionnaire in 100 consecutive patients with epilepsy and 90 controls. The questionnaire includes three validated instruments: the Epworth Sleepiness Scale (ESS) for EDS, SA-SDQ for steep apnea (SA), and the Ullanlinna Narcolepsy Scale (UNS) for narcolepsy. Steep complaints were reported by 30% of epilepsy patients compared to 10% of controls (p = 0.001). The average total steep time was similar in both groups. Insufficient steep times were suspected in 24% of patients and 33% of controls. Steep maintenance insomnia was more frequent in epilepsy patients (52% vs. 38%, p = 0.06), whereas nightmares (6% vs. 16%, p = 0.04) and bruxism (10% vs. 19%, p = 0.07) were more frequent in controls. Sleep onset insomnia (34% vs. 28%), EDS (ESS >= 10, 19% vs. 14%), SA (9% vs. 3%), restless legs symptoms (RL-symptoms, 18% vs. 12%) and most parasomnias were similarly frequent in both groups. In a stepwise logistic regression model loud snoring and RL-symptoms were found to be the only independent predictors of EDS in epilepsy patients. In conclusion, steep-wake habits and the frequency of most steep disorders are similar in non-selected epilepsy patients as compared to controls. In epilepsy patients, EDS was predicted by a history of loud snoring and RL-symptoms but not by SA or epilepsy-related variables (including type of epilepsy, frequency of seizures, and number of antiepiteptic drugs). (C) 2006 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.