Seizure severity and health-related quality of life of adult Nigerian patients with epilepsy.

OBJECTIVES: There is paucity of information about the association of seizure severity and quality of life in people with epilepsy (PWE) in sub-Saharan Africa. We evaluated the relationship of seizure severity to health-related quality of life of patients with epilepsy being followed up in an outpatient neurology clinic in southwestern Nigeria. MATERIALS AND METHODS: Eighty-eight consecutive patients with epilepsy who met the recruitment criteria completed the study questionnaire in company of an eyewitness. The study questionnaire comprised of the National Hospital Seizure Severity Scale (NHS3), the Quality of Life Inventory in Epilepsy (QOLIE-31), and the Beck's Depression Inventory-II (BDI-II). RESULTS: We found a minute association between seizure severity and QOLIE-31 total score (r = -0.262, P = 0.014). Increased seizure severity predicted a worse QOLIE-31 seizure worry (R(2) = 0.311, ß = -0.289; P = 0.003). Of the seven seizure severity items, generalization of seizures and presence of falls were items that predicted a worse QOLIE-31 seizure worry score and time to recover predicted a worse QOLIE-31 total score. CONCLUSIONS: Reducing seizure severity may be an alternate endpoint in epilepsy care in Nigeria (particularly difficult to control seizures) because of its practical clinical relevance in view of the fact that state-of-the-art epilepsy care is still farfetched.

Quality of sleep among hypertensive patients in a semi-urban Nigerian community: a prospective study.

BACKGROUND: Sleep complaints are common in patients with chronic medical disorders; however, the prevalence of "poor sleep" in patients with chronic hypertension is not yet known in Nigeria. In the general population, insomnia negatively impacts quality of life. OBJECTIVE: The objective of this study was to examine the quality of sleep among Nigerian hypertensive patients. The study aimed to measure the prevalence of "poor sleep" in hypertensive patients and to examine the association between quality of sleep and the severity of hypertension in this population. METHODS: Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) in chronic hypertensive patients attending a tertiary hospital in Nigeria. This was compared with normal control subjects. RESULTS: The mean age of the hypertensive patients was 58.15 +/- 9.65 years (range, 19 - 76 years). This did not differ from the controls at 58.7 +/- 10.8 years. A total of 80 (60.6%) respondents were females with a mean age of 58.3 +/- 12.2 years while 52 (39.4%) were males with a mean age of 58.8 +/- 11.7 years. The mean body mass index (BMI) was 26.42 +/- 4.13 kg/m2 (range, 18.9 - 36.4 kg/m2), with 63.1% of the respondents being either overweight or obese. The mean systolic blood pressure was 167.4 +/- 21.8 mm Hg (range, 100 - 210 mm Hg) while the mean diastolic blood pressure was 96.7 +/- 14.9 mm Hg (range, 60 - 130 mm Hg). Fifty-six (42.4%) hypertensive subjects were "poor sleepers" (global PSQI > 5), with a global mean PSQI of 5.03 +/- 3.28. This was significantly more than 17.3% of control subjects, with a mean global PSQI of 3.10 +/- 0.83. Among the hypertensives, there was no statistically significant relationship between the global PSQI and the age (P = 0.653), sex (P = 0.710), BMI (P = 0.253), systolic (P = 0.145), and diastolic blood pressure (P = 0.827). CONCLUSIONS: Poor sleep is common in hypertensive patients and may be associated with lower health-related quality of life. Large-scale, prospective, longitudinal studies on quality of sleep in hypertensive patients are needed to confirm the high prevalence of impaired quality of sleep in this population and to examine the association between severity of hypertension and quality of sleep while controlling for potential confounding variables. We hypothesize that severity of hypertension directly influences quality of sleep, and poor quality of sleep may worsen hypertensive conditions.