PREDICTORS OF SLEEPINESS IN EPILEPSY PATIENTS

Sleepiness, a common complaint of epilepsy patients, is frequently att ributed to antiepileptic medications. To determine predictors of subje ctive sleepiness in epilepsy patients, we gave self-administered, vali dated surveys of sleepiness [Epworth sleepiness scale (our major outco me measure)] and sleep apnea [sleep apnea scale of the sleep disorders questionnaire (SA/SDQ)] to 158 epilepsy patients and 68 neurology pat ients without epilepsy (controls). An elevated Epworth score (>10) was more likely in epilepsy patients compared to controls after controlli ng for age and gender (p < 0.05). When Epworth scores were adjusted fo r SA/SDQ scores and restless legs symptoms (RLS), however, epilepsy pa tients showed only a nonsignificant trend toward elevated Epworth scor es compared to controls (p = 0.08). SA/SDQ scores (p < 0.005) and RLS (p < 0.007) were significant predictors of elevated Epworth score in b oth epilepsy patients and controls. Among the epilepsy patients, the n umber or type of antiepileptic medication, seizure frequency, epilepsy syndrome (partial vs, generalized), and the presence of sleep-related seizures were not significant predictors (p > 0.10) of elevated Epwor th score. Before attributing sleepiness in epilepsy patients to antiep ileptic medications or uncontrolled seizures, clinicians should consid er the possibility of a coexisting sleep disorder.