Quality of Sleep and Excessive Daytime Sleepiness Among Patients With Epilepsy at Kenyatta National Hospital

Abstract

Background Patients living with epilepsy frequently report poor sleep quality and excessive daytime sleepiness which have been linked to seizure occurrence, seizure frequency and poor quality of life Objective To determine burden of Poor quality of sleep, excessive daytime sleepiness, and impact on quality of life in ambulatory patients with epilepsy. Methods The study was a descriptive cross sectional study carried out at Kenyatta National Hospital Neurology Outpatient clinic among ambulatory patients with epilepsy aged 13 years and above. Relevant sociodemographic and clinical data were collected with consent. Demographic characteristics, clinical characteristics, and epilepsy-related variables were summarized using frequency distributions and percentages. Global quality of sleep scores was summarized using frequency distributions either as good sleep (<5) and poor sleep (>5).The Prevalence of excessive daytime sleepiness and poor quality of life were determined. Associations between poor quality of sleep, excessive daytime sleepiness, epilepsy related variables and quality of life were assessed using Chi-square test at 95% confidence level. Probability values <0.05 showed statistical significance. Results The study, conducted between November and December 2022, involved screening 177 epilepsy patients, with 169 eventually being recruited. Out of these 56.2% were male and 43.8% were female with a mean age of 30.7±14.2 years. The duration of epilepsy for most of the participants was > 10 years (42.0%).Majority experienced generalised tonic seizures (72.8%) and 50.3 % had poor seizure control (≥ 1 seizure in last 4 weeks).One hundred and fifteen (68.0%, 95% CI=60.5-75.0%.) had poor sleep quality, and 60 (35.5%, 95% CI= 28.3-43.2%.) had excessive daytime sleepiness. The prevalence of poor quality of life was 41.4% (95% CI=33.9-49.2). No significant differences in seizure-related factors were found between participants reporting poor sleep quality or excessive daytime sleepiness, but those experiencing both had poorer quality of life. Conclusion There is a high prevalence of poor sleep quality and excessive daytime sleepiness among PLWE in Kenya and this negatively affects quality of life