Sleep Disturbances in Chinese Children with Epilepsy: Associations with Behavioral Problems and Quality of Life

Abstract

Objective To investigate the association between sleep disturbances and behavioral problems as well as quality of life (QOL) in Chinese children with epilepsy. Methods Caregivers of 167 epileptic children aged 3 to 12 years completed the Child Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), and the Pediatric Quality of Life Inventory (PedsQL™, 4.0 Core). Results The prevalence of sleep disturbances (CSHQ total score >41) in epileptic children was 73.7% [95% CI (66.9%.80.4%)]. Epileptic children with sleep disturbances demonstrated more behavioral problems and lower QOL compared to those without sleep disturbances. Sleep disturbances such as sleep anxiety and daytime sleepiness were associated with more behavioral problems and lower QOL ( p <0.05). Linear regression analyses showed that higher disturbance in sleep duration domain were associated with more behavioral problems, while higher sleep disordered breathing domains was associated with lower QOL ( p <0.05). The interaction between sleep disturbances and behavioral problems in predicting QOL was not significant. The sensitivity analysis using 48 as an alternative cutoff for CSHQ total score obtained consistent results. Conclusion Sleep disturbances occur frequently among Chinese children with epilepsy, and are associated with more behavioral problems and lower QOL. The sleep disturbance-QOL association is unlikely contingent on behavioral problems. This study highlights the necessity of evaluating and treating sleep disturbances multidimensionally among children with epilepsy to promote their whole health and wellbeing.

Five‐year follow‐up of a clinic‐based sleep intervention for paediatric epilepsy: A randomized clinical trial

“…The overall rate of sleep disturbances in children with epilepsy and poor sleep quality in their mothers in our 5‐year follow‐up was 85.7% and 50.0%, respectively, which was not statistically different from the baseline. The high prevalence rates of sleep disturbances were similar to those in children (73.7%) and in mothers (62.0%) reported previously for paediatric epilepsy (Reilly et al, 2018; Zhao et al, 2022). Williamson et al examined sleep and sleep problems in a birth cohort of Australian children, and found 17.0% of children with minimal sleep problems in early childhood had increased sleep problems through middle childhood, and 7.7% had a persistently high level of sleep problems during the entire follow‐up period from birth to age 11 years (Williamson et al, 2019b).…”

“…b Differences were expressed as intervention relative to usual care group. reported previously for paediatric epilepsy (Reilly et al, 2018;Zhao et al, 2022). (Williamson et al, 2019b).…”

“…If left untreated, sleep disturbances during childhood can persist into adolescence and even into young adulthood (Fernandez‐Mendoza et al, 2022; Hysing et al, 2020). Sleep disturbances in children with epilepsy are more prevalent and serious than in their healthy peers, with a prevalence rate as high as 53%–74% (Gupta et al, 2021; Winsor et al, 2021; Zhao et al, 2022). They also create a significant health and caregiving burden for parents and families (Larson et al, 2012; Tsai et al, 2020b; Yang et al, 2020).…”