A Pilot Study to Assess a Teaching Intervention to Improve Sleep–Wake Disturbances in Parents of Children Diagnosed With Epilepsy

Abstract

Aims: The aim of this study was to assess the impact of screening and teaching interventions for sleepYwake disturbances in parents of childhood patients with epilepsy. Methods: This was a prospective, descriptive study using convenience sampling. After informed consent was obtained from eligible parents who agreed to participate, study questionnaires were administered. All parents were provided with an individualized teaching intervention. Study tools were readministered 8Y12 weeks later to evaluate if the individualized teaching intervention altered or improved sleepYwake disturbances. Results: The t value for the paired t test of the Epworth Sleepiness Scale prescore and postscore was 0.000 with a two-tailed probability value of 1.000, and the t value for the paired t test of the Pittsburgh Sleep Quality Index prescore and postscore was 0.713 with a two-tailed probability value of .492, indicating no significant difference between pre and post Epworth Sleepiness Scale or Pittsburgh Sleep Quality Index scores. Conclusions: A sleep hygiene teaching intervention for parents of children with epilepsy was not effective in this setting of an inner-city epilepsy monitoring unit in changing postintervention scores on measures of both nighttime sleep quality and daytime sleepiness. These results must be interpreted with caution secondary to the small number included in the initial phase of this study. A larger number of participants will be needed to verify these findings. If the results remain consistent with a larger number, studies evaluating variables of cause may be helpful to determine more effective interventions.

Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis

“…We finally identified four cross-sectional studies, 6 , 15 , 16 , 18 five case–control studies, 5 , 9 , 17 , 23 , 29 one cohort study, 30 and one quasi-experimental study. 31 Among the five case–control studies ( Table 1 ), the comparison groups were composed of parents of healthy children (n = 4) or parents of children with nonepilepsy-related neurodisability (n = 1). Articles were all published in English and from seven different countries, with the United States contributing the majority of 36.4%.…”

“… 30 The quasi-experimental study included multiple measurements of the outcome both before and after the intervention and had a complete follow-up but did not have a control group. 31 …”

“…Seven studies reported sleep quality in a total of 740 parents of children and adolescents with epilepsy using the PSQI total score. 5 , 6 , 9 , 15 , 18 , 23 , 31 Because one study did not find differences in PSQI total score after intervention and another study did not find PSQI total score differences between maternal and paternal caregivers, 9 , 31 pre-intervention PSQI total score and maternal PSQI total score were included in the meta-analysis for sleep quality, respectively. The pooled mean estimate for PSQI total score across the seven studies was 7.03 (95% CI: 6.43 to 7.63; Q = 25.76, p < 0.01; I 2 = 76.71%, Figure 2A ), with substantial heterogeneity observed and evidence of publication bias detected in the funnel plot and Egger’s test ( p = 0.02).…”

“…Only one interventional pilot study with 12 parents of children with epilepsy reported a mean score of 10.58 on the ESS and 58.0% of the parents had an ESS score ≥10 for both pre- and post-intervention, 31 suggesting parents of children with epilepsy experienced significant daytime sleepiness.…”

“…Our pooled PSQI global sleep quality score in this meta-analysis was 6.65, with 6 studies reporting an average PSQI score >5 5 , 6 , 9 , 18 , 23 , 31 which is the original PSQI cut-off score used to classify individuals as having poor sleep quality. 33 Evidence from two case–control studies further showed that parents of children with epilepsy consistently having poorer sleep quality than parents of healthy children.…”