141 Journal of Clinical Sleep Medicine, Vol. 9, No. 2, 2013 non-epileptic spells and pregnant patients were excluded from the analysis. Patient with history of cardiovascular accidents and history of mental retardation were not excluded, as none of these conditions involved language disability or mental disability of the degree to preclude reliable survey response. Of 195 patients eligible for entry in the study, 14 were excluded because of in- complete questionnaire data. Another 29 patients were excluded because of known history of sleep disorders fulfilling diagnos- tic criteria of the International Classification of Sleep Disorders and confirmed by a sleep specialist. 19,20 Comorbid sleep disorders included obstructive sleep apnea, circadian rhythm disorders, narcolepsy, REM behavior disorder, periodic limb movement disorder, and restless legs syndrome. Patients with preexisting diagnosis of insomnia were not excluded from the study. Specifically, when diagnosis had to be supported by poly- somnogram findings, obstructive sleep apnea was defined as apnea-hypopnea index ≥ 5 events per hour, and periodic limb Study Objectives: Although disturbed sleep has been fre- quently reported in patients with seizures, little is known about insomnia and epilepsy. The aims of this study were (1) to ana- lyze the prevalence and degree of insomnia in patients with epilepsy, (2) to examine the clinical features and correlates of insomnia in these patients, and (3) to evaluate the impact of poor sleep on their quality of life. Methods: One hundred-fifty-two patients with epilepsy (mean age 46 years) completed the following questionnaires: Insom- nia Severity Index, Pittsburgh Sleep Quality Index, Beck De- pression Inventory-II, Quality of Life in Epilepsy Inventory-31. Patients with other known sleep disorders, including obstruc- tive sleep apnea, were excluded from the study. Regression analysis was conducted for adjusting for age, years since epi- lepsy onset, number of antiepileptic drugs, comorbidities, and depression scores. Results: More than half of the participants (55%) suffered from insomnia and more than 70% were “poor sleepers.” Insomnia and poor sleep quality were significantly correlated with the number of antiepileptic medications and scores of depressive symptoms. After controlling for covariates, insomnia and poor sleep quality were significant predictors of lower quality of life. Conclusion: These results suggest that insomnia and poor sleep are common in patients with epilepsy and may adversely impact quality of life. Further studies should examine whether improvements in sleep can improve seizure control and quality of life of these patients. Keywords: Insomnia, sleeplessness, dyssomnias, seizures, convulsions, epilepsy, depression, anticonvulsants, antiepileptics. Citation: Vendrame M; Yang B; Jackson S; Auerbach SH. Insomnia and epilepsy: a questionnaire-based study. J Clin Sleep Med 2013;9(2):141-146. http://dx.doi.org/10.5664/jcsm.2410 SCIENTIFIC INVESTIGATIONS D isturbed sleep and sleep breathing disturbances are com- mon in patients with epilepsy. 1-5 Polysomnogram stud- ies of patients with epilepsy have shown disrupted sleep with increased sleep onset latency, increased number of nocturnal awakenings, and altered sleep architecture. 6-9 Despite the increasing recognition of sleep disturbances as predictors of quality of life in these patients, 1,10-12 insomnia in ep- ilepsy has been poorly investigated. Some studies have focused on the impact of antiepileptic drugs (AEDs) on sleep quality. 13-15 Overall, the available information on the prevalence and the pre- dictors of insomnia in this patient population is limited. 16-18 The aims of this study were (1) to analyze the prevalence and degree of insomnia in patients with epilepsy, (2) to examine the clinical features and predictors of insomnia in these patients, and (3) to evaluate the impact of poor sleep on their quality of life. METHODS Study Population This retrospective study presents an analysis of descriptive data collected at the baseline assessment of adult epilepsy patients seen at the Boston University Neurology outpatient clinic. Data were collected consecutively between July 2010 and October 2011. Assessment of sleep and depressive symptoms with ques- tionnaires was part of standard clinical practice in the epilepsy clinic, and institutional review board approval from Boston Uni- versity was obtained to review these data retrospectively. Patients older than 18 years of age with a physician-confirmed diagnosis of epilepsy were included in the study. In addition, patients with Insomnia and Epilepsy: A Questionnaire-Based Study Martina Vendrame, M.D., Ph.D.; Betty Yang, B.S.; Stephanie Jackson, M.D.; Sanford H. Auerbach, M.D., F.A.A.S.M. Neurology Department, Boston University, Boston MA BRIEF SUMMARY Current Knowledge/Study Rationale: Despite significant research on the prevalence and health impact of sleep disorders in patients with seizures, there is a relative paucity of data on insomnia among these patients. This study describes the prevalence and clinical features of in- somnia in epilepsy patients and its impact of their quality of life. Study Impact: Our study increases the awareness that insomnia and poor sleep quality are common in a clinical cohort of patients with epi- lepsy, and these may adversely impact their quality of life. These find- ings highlight the need for increased screening by healthcare providers, and for further research exploring whether treatment of insomnia may improve seizure control in these patients.