Sleep disorders in children with epilepsy

Neurologia (Engl Ed). 2021 Sep 10:S0213-4853(21)00114-6. doi: 10.1016/j.nrl.2021.05.014. Online ahead of print.
[Article in English, Spanish]

Abstract

Introduction: Children with epilepsy present greater prevalence of sleep disorders than the general population. Their diagnosis is essential, since epilepsy and sleep disorders have a bidirectional relationship.

Objective: Determine the incidence of sleep disorders and poor sleep habits in children with epilepsy.

Methods: We conducted a cross-sectional study of patients under 18 years of age with epilepsy, assessing sleep disorders using the Spanish-language version of the Sleep Disturbance Scale for Children (SDSC), and sleep habits using an original questionnaire.

Results: The sample included 153 patients. Eighty-four percent of our sample presented some type of sleep alteration. The most frequent alterations were sleep-wake transition disorders (53%), sleep initiation and maintenance disorders (47.7%), and daytime sleepiness (44.4%). In 70% of cases, the patients' parents reported that their child "slept well," although sleep disorders were detected in up to 75.7% of these patients. Many patients had poor sleep habits, such as using electronic devices in bed (16.3%), requiring the presence of a family member to fall asleep (39%), or co-sleeping or sharing a room (23.5% and 30.5%, respectively). Those with generalised epilepsy, refractory epilepsy, nocturnal seizures, and intellectual disability were more likely to present sleep disorders. In contrast, poor sleep habits were frequent regardless of seizure characteristics.

Conclusions: Sleep disorders and poor sleep habits are common in children with epilepsy. Their treatment can lead to an improvement in the quality of life of the patient and his/her family, as well as an improvement in the prognosis of epilepsy.

Keywords: Behavioural insomnia; Co-sleeping; Colecho; Epilepsia; Epilepsy; Insomnio conductual; Neurodesarrollo; Neurodevelopment; Sleep; Sleep disorders; Sueño; Trastornos de sueño.