The relationship between sleep quality and the severity of insomnia with the frequency of seizures in epileptic patients

Abstract

Sleep is a physiological condition which able to modulate seizures through the involvement of widespread circuits, including thalamocortical pathways. The release of epileptiform can be either activated or inhibited based on the ongoing stage of sleep. Epileptiform release tends to spread during NREM sleep for the synchronization occurs more, while synchronized waves tend to do dominate the REM sleep. The reduction of sleep duration is related to seizure as well as the release of epileptiform waves in epileptic patients. This study was aimed to know the relationship between insomnia and sleep quality and insomnia with the frequency of seizure in a patient with epilepsy in RSUP Dr. Wahidin Sudirohusodo and its networking hospitals, Hospital of Universitas Hasanuddin as well as Neurologist private clinic in Makassar. This was an observational study with a cross-sectional approach involving 31 respondents who met the inclusion criteria. Sleep quality was measured by the PSQI questionnaire (Pittsburgh Sleep Quality Index) during the degree of insomnia with the ISI (Insomnia Severity Index) questionnaire. Samples were taken using a consecutive method. 11 (33.5%) participants were found to have a good quality of sleep, and 20 (64.5%) others had bad ones. Moreover, 8 (25.8%), 5 (16.1%), and 15 (58.1%) participants were mild, moderate, and without insomnia, respectively. Data analysis using the chi-square test showed p-value 0.427 (>0.05) and 0.020 (<0.05) for the correlation of sleep quality as well as the degrees of insomnia toward the frequency of seizure, respectively. Sleep quality is not correlated to the frequency of seizure, while the degree of insomnia was found to be correlated to the frequency of seizure. The frequency of seizure in moderate insomnia was higher compared to the frequency in patients without insomnia.

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