Co-morbid sleep problems, in turn, lead to a poorer quality of life in adults. The association between epilepsy and sleep architecture alterations has been demonstrated especially in the context of refractory or difficult to treat epilepsy. However, studies include heterogeneous populations and methodological variations often precluding comparison. Treatment of sleep disorders in this population of patients with epilepsy is likely to improve the quality of life and daily functioning along with improved seizure control.

169 unselected patients with epilepsy were recruited from secondary medical care, tertiary medical care, and university hospitals. Sleep quality and daytime sleepiness were evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth sleepiness scale (ESS) respectively. Polysomnography (PSG) was done to assess the sleep architecture. The phases of sleep studied included sleep time, sleep, efficacy, arousal index, mean oxygen saturation, rapid eye movement (REM) phase, and non-REM (NREM) phases NREM 1, NREM 2, and NREM 3. Respiratory function during sleep was evaluated.

Among 169 patients with epilepsy, 41 with refractory epilepsy with a mean age of 33.76+11.92 years, a mean bodyweight of 63.79+1.30 kg, and a mean body mass index (BMI) of 24.09+4.48 kg/m². Forty-seven (28.1%) patients with epilepsy had daytime sleepiness by ESS. The mean PSQI score is 11.35+3.45. PSG showed mean sleep efficacy 88.66+9.93.33 (19.5%) patients were found to have OSA (AHI ≥15). Periodic limb movements (PLMD) did not observe in our patients. There were no significant differences in sleep efficacy, the index of total arousal index, percentage non-rapid-eye-movement and rapid-eye-movement, and average and least oxygen saturation (SatO2) between patients who had controlled and refractory epilepsy. 

PSG revealed no statistical significant difference in sleep architecture between medically refractory and controlled epilepsy.