0896 Predictors of Total Sleep Duration in Adults with Epilepsy

Abstract

Abstract Introduction Sleep deprivation is a common seizure trigger in adults with epilepsy (AWE). Yet, few prospective studies explore the relationship between seizure control and sleep duration. We studied factors associated with sleep duration in AWE participating in a prospective, cross sectional study investigating prevalence of sleep disorders. We hypothesized seizure frequency would be inversely associated with sleep duration. Methods Participants were AWE with quantifiable seizures who completed PSG, validated instruments and seizure/sleep diaries for at least 7 days in whom prior knowledge of sleep disorder symptoms was unknown. Linear regression models were fit for Total Sleep Duration (TSD; average sleep duration during the major sleep period) and 24-hour TSD (TSD24; average sleep duration during the major sleep period + daytime naps). Independent variables were monthly seizure frequency excluding auras(MSF), monthly generalized seizure frequency(GSF), epilepsy classification (focal vs. generalized), Beck Depression Inventory(BDI) and Insomnia Severity Index(ISI) scores, age, sex, body mass index(BMI), anti-seizure medication(ASM) number and standardized dose and apnea hypopnea index(AHI). Analyses were performed based on significance level 0.05, using SAS (version 9.4, Cary, NC). Results The sample included 126 participants (age 37.5(IQR:28,49), 67.5% female, BMI 28.0(IQR:24.0,32.3), 74.6% focal epilepsy). TSD was 7.5 + 1.9hr and TSD24 7.5 + 1.9hr. Median MSF was 0.5(IQR:0.0,4.0) with 75% having >1 seizure/mo. Median GSF was 0.75 + 9.1 with 19% having >1/mo. Median standardized ASM dose was 1.8(IQR:0.8,2.5) and 46.8% took monotherapy. After adjustment, female sex and ISI were inversely associated with TSD (female sex -1.01, 95%CI[-1.56,-0.17]; ISI -0.09, 95%CI[-0.15,-0.02]) and TSD24 (female sex -1.44, 95%CI[-2052,-0.37]; ISI -0.09, 95%CI[-0.17,-0.01]). GSF>1 was associated with longer TSD24 than those with GSF < 1(2.26, 95%CI[1.03,3.50] vs. 0.43, 95%CI[-0.49,1.35]). With every 1-unit increase in GSF, TSD24 increased 0.22hr(coefficient 0.22, 95%CI[0.07,0.36]). Other epilepsy-related variables were not associated with sleep duration. Conclusion In this first detailed analysis of TSD in AWE, female sex and higher insomnia severity were associated with shorter TSD and TSD24, and higher GSF was associated with longer TSD24. Neither TSD nor TSD24 were associated with MSF. These findings may inform future studies investigating sleep in AWE. Support (if any)