Background. Sleep complaints are common in patients with epilepsy (PWE). Excessive daytime sleepiness (EDS) is one of the most reported complaints and its impact is still a matter of debate. Objective. Evaluate the relationship between EDS and epilepsy, with emphasis on prevalence, assessment, and causes. Methods. A systematic review on PubMed database in the last 10 years (2002 to 2012). The search returned 53 articles and 34 were considered relevant. After citation analysis, 3 more articles were included. Results. Most studies were cross-sectional and questionnaire based. 14 papers addressed EDS as the primary endpoint. 14 adult and 3 children studies used subjective and objective analysis as methodology. The number of studies increased throughout the decade, with 21 in the last 5 years. Adult studies represent almost three times the number of children studies. EDS prevalence in PWE varies from 10 to 47.5%. Prevalence was higher in developing countries. Conclusion. EDS seems to be related more frequently to undiagnosed sleep disorders than to epilepsy-related factors, and although it affects the quality of life of PWE, it can be improved by treating comorbid primary sleep disorders. 1. Introduction Sleep disorders are now recognized as a major impairment in quality of life and work productivity. These complaints are especially common in patients with epilepsy (PWE) normally with more severe consequences than in the general population [1]. Fragmented or inadequate sleep can exacerbate daytime drowsiness and memory dysfunction, which are already present in epilepsy either because of the pathological substrate or the use of antiepileptic drugs (AEDs) and also contribute to intractable seizures [1]. There is a cycle created by sleep disruption leading to worsening seizures, which in turn leads to an even greater impairment of sleep [1]. One of the most reported sleep-related complaints in PWE is excessive daytime sleepiness (EDS) and it has been mainly interpreted as a side effect of AEDs treatment and frequent seizures [2, 3]. This does not seem to be the case. Several studies have shown that EDS in PWE is comparable to that of controls and that symptoms suggestive of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) are stronger predictors of subjective daytime sleepiness than frequency of seizures or AED [2, 3]. One of the problems faced by studies addressing EDS specifically is that a uniform operational definition is still lacking, probably because it is not a disease or a disorder but a symptom presented in primary sleep disorders, such
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