Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Department of Emergency, Linyi Central Hospital, Linyi, China.
BMC Psychiatry. 2022 Jul 25;22(1):497. doi: 10.1186/s12888-022-04154-0.
The association between insomnia and quality of life (QOL) in epilepsy is poorly understood and may involve interactive variables. We aimed to investigate whether and how insomnia, levels of depression and anxiety symptoms interact to influence QOL in people with epilepsy (PWE).
A consecutive cohort of 179 PWE was enrolled. We collected data on insomnia, levels of depression and anxiety symptoms, and QOL. The Insomnia Severity Index (ISI), Depression Inventory for Epilepsy (NDDI-E), Generalized Anxiety Disorder-7 (GAD-7), and QOL in Epilepsy Inventory (QOLIE-31) were used. The direct, indirect, and total effects of insomnia on QOL were estimated based on a moderated mediation model.
Depression symptom levels mediated the association between insomnia and QOL (B = 0.09 SE = 0.03, p = 0.01). Depression symptom levels accounted for 34.7% of the total effect of insomnia on QOL. The mediating effect of depression symptom levels was positively moderated by anxiety symptom levels (B = 0.09, SE = 0.03, p = 0.01).
The effect of insomnia on QOL can be partially explained by the mediation of depression symptom levels. Additionally, improving anxiety symptoms may attenuate the indirect effect of insomnia on QOL through depression symptom levels.
癫痫患者的失眠与生活质量（QOL）之间的关联尚未得到充分理解，并且可能涉及交互变量。我们旨在研究失眠、抑郁和焦虑症状的严重程度如何相互作用，影响癫痫患者（PWE）的 QOL。
连续纳入了 179 名 PWE。我们收集了失眠、抑郁和焦虑症状以及 QOL 的数据。使用了失眠严重程度指数（ISI）、癫痫抑郁量表（NDDI-E）、广泛性焦虑症 7 项量表（GAD-7）和癫痫生活质量量表（QOLIE-31）。基于中介调节模型，估计了失眠对 QOL 的直接、间接和总影响。
抑郁症状严重程度介导了失眠与 QOL 之间的关联（B=0.09，SE=0.03，p=0.01）。抑郁症状严重程度占失眠对 QOL 总影响的 34.7%。焦虑症状严重程度正向调节抑郁症状严重程度的中介作用（B=0.09，SE=0.03，p=0.01）。
失眠对 QOL 的影响部分可以通过抑郁症状严重程度的中介作用来解释。此外，改善焦虑症状可能会通过抑郁症状严重程度减弱失眠对 QOL 的间接影响。
