Calidad del sueño y somnolencia diurna en la epilepsia: una revisión sistemática y metaanálisis actualizado de 26 estudios que incluyeron 6,318 pacientes

Introduction: Sleep disturbances are common in patients with epilepsy and may negatively affect quality of life. The aim of this study was to quantitatively synthesize the available evidence on sleep quality and daytime sleepiness in patients with epilepsy compared with healthy controls. Methods: A systematic review and meta-analysis were conducted, including observational studies comparing these populations using the Pittsburgh Sleep Quality Index (PSQI) and/or the Epworth Sleepiness Scale (ESS). Standardized mean differences (SMDs) were calculated due to the subjective nature of the scales, using a random-effects model with Hartung–Knapp–Sidik–Jonkman adjustment. Heterogeneity and publication bias were assessed, and the certainty of evidence was evaluated using the GRADE approach. Results: Twenty-six studies were included, comprising a total of 6,318 participants (2,023 patients with epilepsy and 4,296 healthy controls). The meta-analysis showed poorer subjective sleep quality in patients with epilepsy (PSQI: SMD −0.54; 95% CI −1.04 to −0.04; p = 0.04). For daytime sleepiness, a small but statistically significant increase was observed (ESS: SMD 0.26; 95% CI 0.07 to 0.46; p = 0.01; I² = 77%). Conclusions: Patients with epilepsy exhibit poorer sleep quality and increased daytime sleepiness compared with healthy controls. These findings highlight the importance of systematically assessing sleep as part of routine clinical practice in patients with epilepsy.