Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
BMC Public Health. 2024 Sep 4;24(1):2412. 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.
癫痫患者（PWE）经常经历睡眠障碍，这会严重影响他们的生活质量。抑郁也是 PWE 人群中的常见症状，会加重睡眠问题。然而，癫痫、抑郁和睡眠障碍之间的相互作用尚未完全了解。我们的研究旨在调查美国成年人癫痫与睡眠障碍之间的关联，并确定抑郁症状是否在这种关系中起中介作用。
我们分析了 2015 年 1 月 1 日至 2020 年 3 月期间（大流行前）全国健康和营养检查调查（NHANES）的数据。共纳入了 10093 名年龄≥20 岁、癫痫和睡眠障碍完整数据的参与者。使用加权多逻辑回归和中介分析来探讨抑郁、癫痫和睡眠障碍之间的关联。还研究了癫痫与各种协变量之间的交互效应。
癫痫与抑郁和睡眠障碍有关。加权逻辑回归分析显示，癫痫与睡眠障碍之间存在显著关联（OR=3.67，95%CI=1.68-8.04）。抑郁部分介导了这种关系，表现出 23.0%的中介效应（间接效应=0.037，P<0.001）。亚组分析显示，在不同组中，癫痫与睡眠障碍之间的关系存在差异。此外，交互分析显示，癫痫与年龄（P=0.049）和高血压（P=0.045）之间存在显著交互作用。
我们利用 NHANES 数据的研究证实，抑郁部分介导了癫痫与睡眠障碍之间的关联。此外，我们观察到这种关联在不同人群中存在差异。在 PWE 中解决抑郁症状可能会改善他们的睡眠质量，但需要进一步研究来探讨潜在机制。
