Sleep Quality and Seizure Recurrence in Adult Epilepsy Patients: A Cross-Sectional Study at Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Abstract

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures. Sleep disturbances may increase seizure recurrence, yet evidence on their association remains limited, particularly in Indonesia. Objective: This study aimed to analyze the association between sleep quality and seizure recurrence, as well as its correlation with seizure frequency among patients with epilepsy. Methods: This study employed a quantitative approach using an analytical observational design with a cross-sectional framework. The study participants were patients with epilepsy who met the predefined inclusion criteria. Data regarding sleep quality, sleep patterns, and excessive daytime sleepiness were collected using validated questionnaire instruments, while seizure recurrence data were obtained from patients’ clinical histories. Results: A total of 34 patients were included in the analysis. Poor sleep patterns were significantly associated with seizure recurrence (p < 0.001; OR = 75.0; 95% CI: 6.99–805.23), although the wide confidence interval indicates uncertainty due to the small sample size. Excessive daytime sleepiness was not significantly associated with seizure recurrence (p = 0.078). Sleep patterns showed a strong correlation with seizure frequency (r = 0.807; p < 0.001), while excessive daytime sleepiness demonstrated a moderate correlation (r = 0.456; p = 0.007). The Pittsburgh Sleep Quality Index (PSQI) demonstrated good discriminatory ability for seizure recurrence (AUC = 0.931; cut-off value ≥5). Conclusion: Poor sleep quality is significantly associated with seizure recurrence and increased seizure frequency among patients with epilepsy. Routine screening using the Pittsburgh Sleep Quality Index (PSQI) with a cut-off value of ≥5 may support seizure management and requires further validation through longitudinal studies.