The impact of sleep patterns, screen exposure and lifestyle factors on seizure frequency in epilepsy: an observational study

Background: Epilepsy is a chronic neurological disorder influenced not only by pharmacological management but also by modifiable lifestyle factors such as sleep habits, screen exposure, stress, and diet. However, real-world evidence integrating these variables remains limited. This observational study aimed to assess the relationship between sleep patterns, screen exposure, and other daily lifestyle factors and seizure frequency in patients with epilepsy. Results: Ninety patients with epilepsy (49 males, 41 females; mean age 31.1 ± 10.7 years) were prospectively followed for three months. Seizure frequency showed significant associations with several lifestyle factors. Consistent sleep schedules, longer sleep duration, and higher subjective sleep quality were correlated with better seizure control (p < 0.001). Conversely, frequent night awakenings, feeling unrefreshed upon waking, and high stress levels were linked to increased seizure frequency (p < 0.01). Poor family support and skipping meals were also significantly associated with worse seizure outcomes (p < 0.01). Moderate caffeine intake was weakly associated with fewer seizures (p < 0.05), while cigarette smoking showed no significant effect. No relationship was observed between seizure frequency and screen exposure variables, including daily and evening screen time, use in bed, or duration before sleep. Conclusion: This study highlights that modifiable lifestyle factors, particularly those related to sleep quality and regularity, stress management, family support, and meal consistency, play a pivotal role in seizure control among patients with epilepsy. Routine screening and counseling regarding these factors should be integrated into epilepsy care to complement pharmacological therapy. Screen exposure did not demonstrate a direct effect on seizure frequency, suggesting its influence may be indirect through sleep disruption. Encouraging stable sleep–wake patterns, regular meals, and stress reduction may represent simple yet effective behavioral strategies to enhance seizure control and overall quality of life in epilepsy patients.