Sleep problems in epilepsy and their implications

Ozalp Ekinci, Uğur Isik, Serkan Gunes, Nuran Ekinci.  Understanding sleep problems in children with epilepsy: Associations with quality of life, Attention-Deficit Hyperactivity Disorder and maternal emotional symptoms.  Seizure - European Journal of Epilepsy, in press 06/28/2016.

Abstract

Purpose

This study aimed to (1) compare sleep problems between children and adolescents with epilepsy and non-epileptic controls, and (2) examine whether there is an association between sleep problems and quality of life, Attention-Deficit Hyperactivity Disorder (ADHD) and mothers’ emotional symptoms.

Methods

Fifty-three patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years) were included. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) for patients and controls. Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used to assess ADHD symptoms for patients. Mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables.

Results

Children with epilepsy had a higher CSHQ Total score than the control group. Those with a CSHQ score >56 (which indicates moderate to severe sleep problems) had lower scores on KINDL-R. Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, STAI trait and Beck scores were found to be higher in those with a CSHQ score >56. Significant positive correlations were found between CSHQ total score and T-DSM-IV-S, STAI trait and Beck scores. Binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score. None of the epilepsy-related variables were found to be related with the CSHQ Total score.

Conclusions

Among children with epilepsy, sleep problems lead to a poor quality of life. The link between sleep problems and psychiatric symptoms must be conceptualized as a bilateral relationship. ADHD appears to be the strongest predictor of sleep problems.

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Article summary:

Methods

Included 53 patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years).

For patients and controls, parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R).

To assess ADHD symptoms for patients Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used.

In this study, mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI).

For the epilepsy-related variables neurology clinic charts were reviewed.

Results

CSHQ Total score was higher in children with epilepsy than the control group.

Those with >56 CSHQ score (which indicates moderate to severe sleep problems) had lower scores on KINDL-R.

Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, in those with a CSHQ score >56 STAI trait and Beck scores were found to be higher.

The study found a remarkably positive correlation between CSHQ total score and T-DSM-IV-S, STAI trait and Beck scores.

In this study, binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score.

As exhibited by the work done in this study, none of the epilepsy-related variables were found to be related with the CSHQ Total score.

http://www.mdlinx.com/neurology/medical-news-article/2016/06/28/epilepsy-children-sleep-adhd-anxiety/6735118/?category=sub-specialty&page_id=1&subspec_id=317