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. 2023 Jan:138:109015.
doi: 10.1016/j.yebeh.2022.109015. Epub 2022 Dec 5.

Sex differences in variables associated with excessive daytime sleepiness in patients with epilepsy

Matthew T Scharf  1 , Patricia Greenberg  2 , Stephen Wong  3 , Ram Mani  4
Affiliations

Sex differences in variables associated with excessive daytime sleepiness in patients with epilepsy

Matthew T Scharf et al. Epilepsy Behav. 2023 Jan.

Abstract

Objective: Excessive daytime sleepiness (EDS) is common in patients with epilepsy (PWE). The Epworth Sleepiness Scale (ESS) is a self-reported measure of sleepiness in widespread use. The purpose of this study was to identify contributors to the ESS score in PWE and to identify variables associated with a high score indicative of EDS.

Methods: A cross-sectional study was performed on 115 PWE presenting to the epilepsy clinic. Self-reported questionnaires were administered and demographic and clinical information was gathered from the electronic medical record. Regression analyses were performed.

Results: A high ESS score was found in nearly 20% of the cohort. Obstructive sleep apnea (OSA) risk, standardized anti-seizure drug (ASD) dose, and female sex were associated with an increased likelihood of a high ESS score. Assessment of the ESS without the use of a cutpoint showed that standardized ASD dose and OSA risk were associated with the ESS in men, but standardized ASD dose was not associated with the ESS in women. Higher use of valproic acid and oxcarbazepine in men and higher use of lamotrigine in women may be contributing factors.

Significance: Sex is likely to be a key factor in determining contributors to EDS in PWE.

Keywords: Anti-seizure drug; Epilepsy; Obstructive sleep apnea; Sex; Sleepiness.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.