A Study on sleep disturbances and comorbid conditions in newly diagnosed, drug-naive epilepsy patients_Journal of Epilepsy

Authors：

MA Xinnan , WANG Pinchun , MA Jingyou , PAN Shengjie , LU Yeting ,  HU Xiaowei

Department of Neurology, The First Affiliated Hospital of Soochow University, Jiangsu, Suzhou 215000, China;

Corresponding?author：

HU Xiaowei, Email: huxiaowei@suda.edu.cn

Keywords：

Epilepsy; Sleep Disorder; Comorbidity; Depression; Anxiety

DOI：

10.7507/2096-0247.202602001

Video：

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Objective This study aimed to investigate the status of sleep disorders and comorbidity profiles in patients with newly diagnosed epilepsy, to inform early intervention strategies. Methods This single-center retrospective study enrolled 24 newly diagnosed epilepsy patients and 28 healthy controls from the Department of Neurology, The First Affiliated Hospital of Soochow University, between April and October 2025. Sleep quality, daytime sleepiness, mood, and cognitive function were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Beck Anxiety Inventory, Beck Depression Inventory-II, and Mini-Mental State Examination, respectively. Intergroup comparisons were conducted for all measures. Results The incidence of sleep disturbance (PSQI>5) was 79.2% in the epilepsy group, significantly higher than the 46.4% observed in the control group, with a statistically significant difference (P<0.05). The epilepsy group demonstrated significantly higher PSQI component scores than the control group in domains of sleep continuity, sleep disturbances, and daytime dysfunction (all P<0.05), reflecting issues with nocturnal sleep fragmentation and daytime impairment. We observed no statistically significant differences between the groups in anxiety, depression, daytime sleepiness, or cognitive function (all P>0.05). Conclusion Newly diagnosed and drug-naive epilepsy patients exhibit significant sleep disturbances, characterized by poor sleep continuity, disrupted sleep architecture, and daytime dysfunction, which appear independent of mood comorbidities.

Citation： MA Xinnan, WANG Pinchun, MA Jingyou, PAN Shengjie, LU Yeting, HU Xiaowei. A Study on sleep disturbances and comorbid conditions in newly diagnosed, drug-naive epilepsy patients. Journal of Epilepsy, 2026, 12(2): 128-133. doi: 10.7507/2096-0247.202602001 Copy

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2.	Garg D, Charlesworth L, Shukla G. Sleep and temporal lobe epilepsy-associations, mechanisms and treatment implications. Front Hum Neurosci, 2022, 16: 849899.
3.	Stirling RE, Hidajat CM, Grayden DB, et al. Sleep and seizure risk in epilepsy: bed and wake times are more important than sleep duration. Brain, 2023, 146(7): 2803-2813.
4.	Sheybani L, Frauscher B, Bernard C, et al. Mechanistic insights into the interaction between epilepsy and sleep. Nat Rev Neurol, 2025, 21(4): 177-192.
5.	Wong LC, Huang CH, Chou WY, et al. The clinical and sleep manifestations in children with FOXG1 syndrome. Autism Res, 2023, 16(5): 953-966.
6.	Xu Y, Hackett ML, Nikpour A, et al. Course and impact of sleep disturbance in newly diagnosed epilepsy: a prospective registry study. Clin Neurol Neurosurg, 2020, 195: 105963.
7.	Grigg-Damberger MM, Foldvary-Schaefer N. Sleep and epilepsy: practical implications. Neurol Clin, 2022, 40(4): 769-783.
8.	de Bergeyck R, Geoffroy PA. Insomnia in neurological disorders: prevalence, mechanisms, impact and treatment approaches. Rev Neurol(Paris), 2023, 179(7): 767-781.
9.	Morin CM, Jarrin DC. Epidemiology of insomnia: prevalence, course, risk factors, and public health burden. Sleep Med Clin, 2022, 17(2): 173-191.
10.	Mogavero MP, Silvani A, Lanza G, et al. Targeting orexin receptors for the treatment of insomnia: from physiological mechanisms to current clinical evidence and recommendations. Nat Sci Sleep, 2023, 15: 17-38.
11.	Zhong R, Li G, Zhao T, et al. Association of baseline sleep duration and sleep quality with seizure recurrence in newly treated patients with epilepsy. Epilepsia, 2024, 65(11): 3224-3233.
12.	Roliz AH, Kothare S. The interaction between sleep and epilepsy. Curr Neurol Neurosci Rep, 2022, 22(9): 551-563.
13.	Zhong R, Zhao T, Li N, et al. Fatigue, sleep quality, depression symptoms, and antiseizure medication resistance in patients with newly diagnosed epilepsy. Ther Adv Neurol Disord, 2025, 18: 17562864251325338.
14.	Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
15.	Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
16.	Bergmann M, Tschiderer L, Stefani A, et al. Sleep quality and daytime sleepiness in epilepsy: systematic review and meta-analysis of 25 studies including 8, 196 individuals. Sleep Med Rev, 2021, 57: 101466.
17.	Kim M, Jung S, Kim JS, et al. The effect of cognitive behavioral therapy on depression of people with epilepsy. Epilepsy Behav, 2023, 148: 109410.
18.	Eck S, Dummler D, Akturk Z, et al. Beck Anxiety Inventory(BAI)for detecting anxiety disorders in adults. Cochrane Database Syst Rev, 2025, 12(12): CD015457.
19.	Rosenberg R, Babson K, Menno D, et al. Test-retest reliability of the Epworth sleepiness scale in clinical trial settings. J Sleep Res, 2022, 31(2): e13476.
20.	Chun CT, Seward K, Patterson A, et al. Evaluation of available cognitive tools used to measure mild cognitive decline: a scoping review. Nutrients, 2021, 13(11): 3974.
21.	Madrid-Valero JJ, Sanchez-Romera JF, Martinez-Selva JM, et al. Phenotypic, genetic and environmental architecture of the components of sleep quality. Behav Genet, 2022, 52(4-5): 236-245.
22.	Strzelcyzk A, Aledo-Serrano A, Coppola A, et al. The impact of epilepsy on quality of life: Findings from a European survey. Epilepsy Behav, 2023, 142: 109179.
23.	Tan B, Liu Q, Qin Y, et al. Insomnia in epilepsy is associated with nocturnal seizures and anxiety. Epilepsy Behav, 2024, 150: 109559.
24.	Wen Q, Wang Q, Yang H. The association between epilepsy and sleep disturbance in US adults: the mediating effect of depression. BMC Public Health, 2024, 24(1): 2412.
25.	Alenizi AA, Eskandrani AM, Asiri SA, et al. Sleep quality, daytime sleepiness, and insomnia in patient with epilepsy: A single center experience from Saudi Arabia. Neurosciences (Riyadh), 2023, 28(1): 19-26.
26.	van Schalkwijk FJ, Ricci M, Nikpour A, et al. The impact of sleep characteristics and epilepsy variables on memory performance in patients with focal seizures. Epilepsy Behav, 2018, 87: 152-158.
27.	Roliz AH, Kothare S. The relationship between sleep, epilepsy, and development: a review. Curr Neurol Neurosci Rep, 2023, 23(9): 469-477.
28.	Wang YQ, Zhang MQ, LI R, et al. The mutual interaction between sleep and epilepsy on the neurobiological basis and therapy. Curr Neuropharmacol, 2018, 16(1): 5-16.

1. Athira SB, Pal P, Nair PP, et al. Influence of sleep disturbance, depression, anxiety, and stress on quality of life in people with epilepsy. Epileptic Disord, 2024, 26(1): 69-78.
2. Garg D, Charlesworth L, Shukla G. Sleep and temporal lobe epilepsy-associations, mechanisms and treatment implications. Front Hum Neurosci, 2022, 16: 849899.
3. Stirling RE, Hidajat CM, Grayden DB, et al. Sleep and seizure risk in epilepsy: bed and wake times are more important than sleep duration. Brain, 2023, 146(7): 2803-2813.
4. Sheybani L, Frauscher B, Bernard C, et al. Mechanistic insights into the interaction between epilepsy and sleep. Nat Rev Neurol, 2025, 21(4): 177-192.
5. Wong LC, Huang CH, Chou WY, et al. The clinical and sleep manifestations in children with FOXG1 syndrome. Autism Res, 2023, 16(5): 953-966.
6. Xu Y, Hackett ML, Nikpour A, et al. Course and impact of sleep disturbance in newly diagnosed epilepsy: a prospective registry study. Clin Neurol Neurosurg, 2020, 195: 105963.
7. Grigg-Damberger MM, Foldvary-Schaefer N. Sleep and epilepsy: practical implications. Neurol Clin, 2022, 40(4): 769-783.
8. de Bergeyck R, Geoffroy PA. Insomnia in neurological disorders: prevalence, mechanisms, impact and treatment approaches. Rev Neurol(Paris), 2023, 179(7): 767-781.
9. Morin CM, Jarrin DC. Epidemiology of insomnia: prevalence, course, risk factors, and public health burden. Sleep Med Clin, 2022, 17(2): 173-191.
10. Mogavero MP, Silvani A, Lanza G, et al. Targeting orexin receptors for the treatment of insomnia: from physiological mechanisms to current clinical evidence and recommendations. Nat Sci Sleep, 2023, 15: 17-38.
11. Zhong R, Li G, Zhao T, et al. Association of baseline sleep duration and sleep quality with seizure recurrence in newly treated patients with epilepsy. Epilepsia, 2024, 65(11): 3224-3233.
12. Roliz AH, Kothare S. The interaction between sleep and epilepsy. Curr Neurol Neurosci Rep, 2022, 22(9): 551-563.
13. Zhong R, Zhao T, Li N, et al. Fatigue, sleep quality, depression symptoms, and antiseizure medication resistance in patients with newly diagnosed epilepsy. Ther Adv Neurol Disord, 2025, 18: 17562864251325338.
14. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
15. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
16. Bergmann M, Tschiderer L, Stefani A, et al. Sleep quality and daytime sleepiness in epilepsy: systematic review and meta-analysis of 25 studies including 8, 196 individuals. Sleep Med Rev, 2021, 57: 101466.
17. Kim M, Jung S, Kim JS, et al. The effect of cognitive behavioral therapy on depression of people with epilepsy. Epilepsy Behav, 2023, 148: 109410.
18. Eck S, Dummler D, Akturk Z, et al. Beck Anxiety Inventory(BAI)for detecting anxiety disorders in adults. Cochrane Database Syst Rev, 2025, 12(12): CD015457.
19. Rosenberg R, Babson K, Menno D, et al. Test-retest reliability of the Epworth sleepiness scale in clinical trial settings. J Sleep Res, 2022, 31(2): e13476.
20. Chun CT, Seward K, Patterson A, et al. Evaluation of available cognitive tools used to measure mild cognitive decline: a scoping review. Nutrients, 2021, 13(11): 3974.
21. Madrid-Valero JJ, Sanchez-Romera JF, Martinez-Selva JM, et al. Phenotypic, genetic and environmental architecture of the components of sleep quality. Behav Genet, 2022, 52(4-5): 236-245.
22. Strzelcyzk A, Aledo-Serrano A, Coppola A, et al. The impact of epilepsy on quality of life: Findings from a European survey. Epilepsy Behav, 2023, 142: 109179.
23. Tan B, Liu Q, Qin Y, et al. Insomnia in epilepsy is associated with nocturnal seizures and anxiety. Epilepsy Behav, 2024, 150: 109559.
24. Wen Q, Wang Q, Yang H. The association between epilepsy and sleep disturbance in US adults: the mediating effect of depression. BMC Public Health, 2024, 24(1): 2412.
25. Alenizi AA, Eskandrani AM, Asiri SA, et al. Sleep quality, daytime sleepiness, and insomnia in patient with epilepsy: A single center experience from Saudi Arabia. Neurosciences (Riyadh), 2023, 28(1): 19-26.
26. van Schalkwijk FJ, Ricci M, Nikpour A, et al. The impact of sleep characteristics and epilepsy variables on memory performance in patients with focal seizures. Epilepsy Behav, 2018, 87: 152-158.
27. Roliz AH, Kothare S. The relationship between sleep, epilepsy, and development: a review. Curr Neurol Neurosci Rep, 2023, 23(9): 469-477.
28. Wang YQ, Zhang MQ, LI R, et al. The mutual interaction between sleep and epilepsy on the neurobiological basis and therapy. Curr Neuropharmacol, 2018, 16(1): 5-16.

Journal of Epilepsy

A Study on sleep disturbances and comorbid conditions in newly diagnosed, drug-naive epilepsy patients

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