THE WAKING BURDEN OF NIGHT-TIME SEIZURES: A SYSTEMATIC REVIEW OF QUALITY OF LIFE IN NOCTURNAL EPILEPSY
Author(s)
Shivom Prajapati, M.Pharm1, Sukriti Sharma, M.Sc1, Sumeet Attri, M.Pharm1, Ritesh Dubey, PharmD1, Rubal Arora, M.Pharm1, Barinder Singh, RPh2, Sunil Kumar, M.Pharm1.
1Pharmacoevidence, Mohali, India, 2Pharmacoevidence, London, United Kingdom.
1Pharmacoevidence, Mohali, India, 2Pharmacoevidence, London, United Kingdom.
OBJECTIVES: Nocturnal epilepsy including nocturnal frontal lobe epilepsy (NFLE) and sleep-related hypermotor epilepsy, is a distinct form of epilepsy in which seizures occur mainly during sleep. Sleep disruption from nocturnal seizures may impair daytime wellbeing, but the relative burden compared with healthy individuals or daytime seizures is unclear. This systematic literature review (SLR) evaluated the health-related quality of life (HRQoL) among adults with nocturnal epilepsy.
METHODS: Key biomedical databases were searched from database inception to June 2026 to identify the relevant studies. The SLR was performed using the Pharmacoevidence AI‑assisted platform (metaSLR), with human reviewers involved at each review stage.
RESULTS: Of 1,058 citations screened, eight studies evaluating HRQoL were included. Across studies, the HRQoL instruments included: Short Form-36 (SF-36, n=3), the Epworth Sleepiness Scale (ESS, n=4), the Pittsburgh Sleep Quality Index (PSQI, n=4), the Quality of Life in Epilepsy-31 (QOLIE-31, n=1), and the Fatigue Severity Scale (FSS, n=1), where higher score indicate worse QoL except for SF-36. Compared with healthy controls, patients with nocturnal epilepsy reported worse daytime sleepiness (ESS: 7.0 vs. 5.5; 5.6 vs. 5.7), significantly poorer sleep quality (PSQI: 9.0 vs. 4.0; p<0.0001), and greater fatigue (FSS: 4.5 vs. 2.6). Adults with NFLE reported lower SF-36 scores than Italian normative data, indicating poor HRQoL. When compared with daytime seizures, nocturnal patients reported greater daytime sleepiness (ESS 9.3 vs. 7.1; 9.2 vs. 6.7), poorer sleep quality (PSQI 6.3-18.5 vs. 6.2-8.4), greater fatigue (FSS 4.5 vs. 3.9), and poorer epilepsy-specific QoL based on QOLIE-31. Conversely, wake-only or mixed seizure patients reported lower SF-36 scores vs. sleep-related seizures (48.5 vs. 64.0; 52.6 vs. 63.2), indicating diminished HRQoL.
CONCLUSIONS: Nocturnal epilepsy is associated with substantial impairment in HRQoL, particularly across sleep-related outcomes. These findings highlight the need for greater recognition of patient burden and its consideration in clinical management.
METHODS: Key biomedical databases were searched from database inception to June 2026 to identify the relevant studies. The SLR was performed using the Pharmacoevidence AI‑assisted platform (metaSLR), with human reviewers involved at each review stage.
RESULTS: Of 1,058 citations screened, eight studies evaluating HRQoL were included. Across studies, the HRQoL instruments included: Short Form-36 (SF-36, n=3), the Epworth Sleepiness Scale (ESS, n=4), the Pittsburgh Sleep Quality Index (PSQI, n=4), the Quality of Life in Epilepsy-31 (QOLIE-31, n=1), and the Fatigue Severity Scale (FSS, n=1), where higher score indicate worse QoL except for SF-36. Compared with healthy controls, patients with nocturnal epilepsy reported worse daytime sleepiness (ESS: 7.0 vs. 5.5; 5.6 vs. 5.7), significantly poorer sleep quality (PSQI: 9.0 vs. 4.0; p<0.0001), and greater fatigue (FSS: 4.5 vs. 2.6). Adults with NFLE reported lower SF-36 scores than Italian normative data, indicating poor HRQoL. When compared with daytime seizures, nocturnal patients reported greater daytime sleepiness (ESS 9.3 vs. 7.1; 9.2 vs. 6.7), poorer sleep quality (PSQI 6.3-18.5 vs. 6.2-8.4), greater fatigue (FSS 4.5 vs. 3.9), and poorer epilepsy-specific QoL based on QOLIE-31. Conversely, wake-only or mixed seizure patients reported lower SF-36 scores vs. sleep-related seizures (48.5 vs. 64.0; 52.6 vs. 63.2), indicating diminished HRQoL.
CONCLUSIONS: Nocturnal epilepsy is associated with substantial impairment in HRQoL, particularly across sleep-related outcomes. These findings highlight the need for greater recognition of patient burden and its consideration in clinical management.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR21
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Neurological Disorders