Differences in factors associated with insomnia symptoms between patients with epilepsy with and without depressive symptoms
- Authors
- Lee, Sang-Ahm; Choi, Eun Ju; Kim, Hyun-Woo; Jeon, Ji-Ye; Han, Su-Hyun; Lee, Gha-Hyun; Ryu, Han Uk; Kim, Boyoung; Kim, Tae-Young
- Issue Date
- Jul-2024
- Publisher
- Academic Press Inc.
- Keywords
- Daytime sleepiness; Depression; Epilepsy; Insomnia; Perampanel; Sleep disturbance
- Citation
- Epilepsy and Behavior, v.156
- Journal Title
- Epilepsy and Behavior
- Volume
- 156
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74224
- DOI
- 10.1016/j.yebeh.2024.109781
- ISSN
- 1525-5050
1525-5069
- Abstract
- Objective: To determine if insomnia-related factors differ depending on the presence of depression in patients with epilepsy. Methods: This cross-sectional multicenter study collected data on depressive symptoms, insomnia symptoms, and excessive daytime sleepiness, which were defined as a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 10, an Insomnia Severity Index (ISI) score of ≥ 15, and an Epworth Sleepiness Scale (ESS) of ≥ 11, respectively. Further, uncontrolled seizures were defined as one or more seizures per month during antiseizure medications treatment. A stepwise logistic regression analysis was conducted, with a logistic regression with interaction terms performed to identify differences in insomnia-related factors depending on depressive symptoms. Results: Of 282 adults with epilepsy (men, 58 %; mean age, 40.4 ± 13.9 years), a PHQ-9 score ≥ 10, an ISI score ≥ 15, an ESS score ≥ 11 were noted in 23.4 % (n = 66), 20.2 % (n = 57), and 12.8 % (n = 36), respectively. More patients with depressive symptoms had an ISI score ≥ 15 (56.1 % vs. 9.3 %; p < 0.001) than those without. In multiple logistic regression, uncontrolled seizures (odds ratio [OR], 4.896; p < 0.01), daytime sleepiness (OR, 5.369; p < 0.05), and a history of psychiatric disorders (OR, 3.971; p < 0.05) were identified as significant factors that were more likely to be associated with an ISI score ≥ 15; however, this was only true in patients without depressive symptoms. In contrast, use of perampanel (OR, 0.282; p < 0.05) was less likely associated, while female sex (OR, 3.178; p < 0.05) was more likely associated with an ISI score ≥ 15 only in patients with depressive symptoms. Conclusions: Insomnia-related factors in patients with epilepsy may differ between patients with and without depression. Our findings of different insomnia-related factors based on the presence of depression may facilitate the management of patients with epilepsy. © 2024 Elsevier Inc.
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