The hidden burden of sleep in adolescents with idiopathic generalized epilepsy

BACKGROUND: Idiopathic Generalized Epilepsies (IGEs) are electroclinical syndromes characterized by distinct seizure types, EEG patterns, and presumed polygenic inheritance. While seizure prognosis is often favorable, sleep disturbances, behavioral and emotional difficulties, and executive function impairment are common, especially during adolescence. OBJECTIVE: To investigate the relationship between subjective sleep quality, emotional-behavioral functioning, and executive functions in adolescents with IGE. METHODS: In this single-center observational study, 28 adolescents (mean age 15.0 ± 2.4 years) with IGE were evaluated with the following standardized measures: PSQI (sleep), BRIEF-2 (executive functions), CBCL and YSR (emotional-behavioral profile), SAFA-A/-D/-S (internalizing and somatic symptoms). Dream-related experiences were also collected. Pearson correlations tested behavioral and emotional associations with sleep quality. RESULTS: Poor sleep quality (PSQI ≥5) occurred in 28.6% of patients, although only 14.8% reported sleep problems in their clinical history. Poor sleepers showed significantly higher anxiety, depression, somatic complaints, and stress-related symptoms (p < .05). Executive function impairment, particularly in emotional control and cognitive flexibility, was more frequent in this group. SIGNIFICANCE: Sleep quality is an under-recognized but clinically relevant dimension in patients with IGE, closely linked to emotional vulnerability and executive function difficulties. Routine sleep screening and targeted sleep-focused management should be integrated into pediatric IGE care to support psychological well-being.