Objective This study aimed to investigate the status of sleep disorders and comorbidity profiles in patients with newly diagnosed epilepsy, to inform early intervention strategies. Methods This single-center retrospective study enrolled 24 newly diagnosed epilepsy patients and 28 healthy controls from the Department of Neurology, The First Affiliated Hospital of Soochow University, between April and October 2025. Sleep quality, daytime sleepiness, mood, and cognitive function were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Beck Anxiety Inventory, Beck Depression Inventory-II, and Mini-Mental State Examination, respectively. Intergroup comparisons were conducted for all measures. Results The incidence of sleep disturbance (PSQI>5) was 79.2% in the epilepsy group, significantly higher than the 46.4% observed in the control group, with a statistically significant difference (P<0.05). The epilepsy group demonstrated significantly higher PSQI component scores than the control group in domains of sleep continuity, sleep disturbances, and daytime dysfunction (all P<0.05), reflecting issues with nocturnal sleep fragmentation and daytime impairment. We observed no statistically significant differences between the groups in anxiety, depression, daytime sleepiness, or cognitive function (all P>0.05). Conclusion Newly diagnosed and drug-naive epilepsy patients exhibit significant sleep disturbances, characterized by poor sleep continuity, disrupted sleep architecture, and daytime dysfunction, which appear independent of mood comorbidities.