Sleep disorders and their relationship to psychological disturbance in children with epilepsy

Abstract

By means of parental questionnaires, sleep disturbances were assessed in 79 schoolchildren with epilepsy (mean age 10.12, range 5-16 years) for comparisons with 73 healthy control children matched for gender and to within a maximum of 6 months of age. The daytime behaviour of the children with epilepsy was also assessed by questionnaire. The children with epilepsy were considered representative of such children under general paediatric care. Sleep disturbance was classified into five basic types (poor quality sleep, anxieties about sleep, disturbances during sleep, symptoms of disordered breathing during sleep and short duration sleep) and the behaviour questionnaire provided scores on five factors (conduct problems, hyperactivity, attention problems, anxiety and physical complaints). Compared with normal controls children with epilepsy showed much higher rates of sleep disorders, particularly poor quality sleep and anxieties about sleep. In children aged 5-11 years associations were found between disturbed daytime behaviour and sleep problems, particularly poor quality sleep. There was also a significant association between seizure frequency and anxieties about sleeping. This study highlights the potentially serious psychological and other developmental implications of persistent sleep disturbance to children with epilepsy, and the need for further research on specific types of epilepsy with careful identification of the nature of both sleep disturbance and related psychological dysfunction.

Sleep Problems and Daytime Behavior in Childhood Idiopathic Epilepsy

“…In the epilepsy group, as expected and already reported (1, 9,20), despite the small number of cases in this group, children with current seizures, although sporadic, showed more sleep problems, including also a longer sleep latency and short nighttime sleep duration, than did those who were seizure free. As already pointed out by Stores et al (20), any differences in sleep problems were seen in children with generalized or partial types of epilepsy.…”

“…Particularly in children aged 5-1 1 years, association between disturbed daytime behavior and sleep problems was found. Furthermore, Stores et al (20) found an association between higher seizure rate and anxieties about sleep.…”

Amygdala opioid receptors mediate the electroacupuncture-induced deterioration of sleep disruptions in epilepsy rats

“…Feng-Chi acupoint (GB 20), located in the depression between the upper portion of m. sternocleidomastoideus and m. trapezius in humans, has been documented in the Lingshu Jing (the Classic of the Miraculous Pivot) and indicated the therapeutic effects in headache, dizziness, hypertension, insomnia and epilepsy. It is commonly observed that there are sleep disruptions, such as daytime somnolence and/or nighttime insomnia, in patients with epilepsy [3,4]. We previously elucidated that kindled epilepsy occurred at different zeitgeber times (ZTs) alters sleep differently; ZT0 kindled epilepsy decreases NREM sleep and REM sleep, and ZT13 kindling, on the other hand, increases NREM sleep [5,6] in experimental animals.…”

“…While rapid eye movement (REM) sleep suppresses seizure activity, non-REM (NREM) sleep facilitates it [1,2]. On the other hand, patients with epilepsy experience more daytime sleepiness compared with control patients [3], and children with epilepsy experience poor quality of sleep, anxiety about sleep, and sleep-disordered breathing [4]. Our previous studies have demonstrated that occurrence of epilepsy at different zeitgeber time points results in different sleep disruptions by altering either the homeostatic factors or circadian rhythm of the sleep-wake regulation in rats [5,6].…”

The contribution of illness perceptions to fatigue and sleep problems in youngsters with epilepsy

“…This finding is not in line with studies that suggest that children with epilepsy show much higher rates of sleep disorders than healthy controls, but it should be noted that in this study sleep problems were assessed using parental questionnaires, while in our study self-reports by youngsters were used. 38 It is quite clear that there is a need for normative fatigue data, derived from a study in healthy youngsters. While the percentage of youngsters reaching clinical levels in this study is thus probably an underestimation, one third of our study population reported clinical levels of sleep problems.…”