The association between epilepsy and sleep disturbance in US adults: the mediating effect of depression

• Published in: BMC public health Vol. 24; no. 1; pp. 2412 - 11
• Main Authors: Wen, Qianhui, Wang, Qian, Yang, Hua
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.09.2024; BioMed Central; BMC
• Subjects: Adult; Adults; Aged; Analysis; Asthma; Blood pressure; Cardiovascular disease; Complications and side effects; Cross-Sectional Studies; Depression; Depression - epidemiology; Depression, Mental; Diabetes; Disturbances; Epilepsy; Epilepsy - epidemiology; Epilepsy - psychology; Female; Health aspects; Health surveys; Humans; Hypertension; Investigations; Male; Marital status; Mediation; Mediation effect; Medical research; Medicine, Experimental; Mental depression; Middle Aged; NHANES; Nutrition Surveys; Physiological aspects; Population; Psychological aspects; Quality of life; Questionnaires; Regression analysis; Risk factors; Secondary schools; Sleep; Sleep disorders; Sleep disturbance; Sleep Wake Disorders - epidemiology; Subgroups; Surveys; United States - epidemiology; Young Adult; United States; China; United States > US; Sleep disturbance; Depression; NHANES; Mediation effect; Epilepsy
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-19898-5

People with epilepsy (PWE) frequently experience sleep disturbances that can severely affect their quality of life. Depression is also a common symptom in the PWE population and can aggravate sleep problems. However, the interplay between epilepsy, depression, and sleep disturbances is not yet fully understood. Our study was designed to investigate the association between epilepsy and sleep disturbances in US adults and to determine whether depressive symptoms play a mediating role in this relationship. We examined data from the National Health and Nutrition Examination Survey (NHANES) spanning January 1, 2015, to March 2020, before the pandemic.A total of 10,093 participants aged ≥ 20 years with complete data on epilepsy and sleep disturbance were included. Weighted multiple logistic regression and mediation analysis were used to explore the associations among depression, epilepsy, and sleep disturbance. Interaction effects of epilepsy with various covariates were also investigated. Epilepsy was associated with depression and sleep disturbances. Weighted logistic regression analysis revealed a significant association between epilepsy and sleep disturbances (OR = 3.67, 95% CI = 1.68-8.04). Depression partially mediated this relationship, demonstrating a mediation effect of 23.0% (indirect effect = 0.037, P < 0.001). Subgroup analyses revealed variations in the relationship between epilepsy and sleep disturbances among different groups. Furthermore, interaction analyses revealed significant interactions between epilepsy and age (P = 0.049) and hypertension (P = 0.045). Our study utilizing NHANES data confirmed that depression partially mediated the association between epilepsy and sleep disturbance. Additionally, we observed differences in this association across demographic groups. Addressing depressive symptoms in PWE may improve their sleep quality, but further research is needed to explore the underlying mechanisms.