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Published on: December 22, 2016
Sleep architecture in children with idiopathic generalized epilepsy
Rama Maganti1, Raj D Sheth, Bruce P Hermann
1Marshfield Clinic-Neurology, Wausau, Wisconsin 53792, USA.
Insights
Children with epilepsy show abnormal sleep patterns, including longer stage 1 sleep and REM latency. These sleep disturbances may be linked to attention deficits and behavioral issues in pediatric epilepsy.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Epilepsy Research
Background:
- Children with epilepsy often exhibit higher rates of sleep disturbances, behavioral problems, and attentional deficits compared to their healthy peers.
- The precise relationship between sleep architecture abnormalities and these daytime challenges in pediatric epilepsy remains incompletely understood.
Purpose of the Study:
- To investigate sleep architecture differences in children with primary generalized epilepsy compared to healthy controls.
- To explore the association between specific sleep parameters and daytime attentional function and behavioral status in children with epilepsy.
Main Methods:
- Nocturnal polysomnography with extended electroencephalography was performed on seizure-free children with primary generalized epilepsy and age/gender-matched healthy controls.
- Daytime attentional function was assessed using the Connor's Continuous Performance Test (CPT), and emotional-behavioral status was evaluated via the Child Behavior Checklist (CBCL).
- Statistical analyses included t tests for group comparisons, Spearman correlations for associations, and multiple regression to identify independent predictors.
Main Results:
- Children with epilepsy demonstrated significantly longer stage 1 sleep percentage and increased latency to rapid-eye-movement (REM) sleep compared to controls.
- Epilepsy patients exhibited poorer attentional performance on the CPT and reported higher scores on CBCL behavior scales.
- While no independent predictors were identified, a trend suggested associations between total behavior problems and REM sleep percentage, and between attention deficits and stage 1 sleep percentage.
Conclusions:
- Children diagnosed with primary generalized epilepsy exhibit altered sleep architecture.
- Further research is warranted to establish a causal link between these sleep architecture abnormalities and the observed impairments in daytime behavior and attention.
Purpose:
Children with epilepsy experience sleep disturbances, behavioral and attentional problems at higher rates than their peers. However, the relation between sleep disturbances and the observed behavioral and attentional abnormalities is poorly defined.
Methods:
Children with primary generalized epilepsy who were seizure free and between the ages of 5 and 18 years were matched with age- and gender-matched healthy controls and underwent two consecutive nights of nocturnal polysomnography with extended electroencephalography. Connor's Continuous Performance Test (CPT) was administered to assess daytime attentional function. Parents completed the Child Behavior Checklist (CBCL) to assess their emotional-behavioral status. Two sample t tests were used to examine group differences. Spearman correlations were used to examine the relation between sleep variables and behavior and attention variables. Multiple regression analysis was used to identify independent predictors of abnormal behavior and attention among patients.
Results:
Eleven children with primary generalized epilepsy and eight age- and sex-matched controls participated in the study. Children with epilepsy had longer stage 1 sleep percentage (7.19 +/- 3.2 vs. 4.8 +/- 3.5; p = 0.05) and latency to rapid-eye-movement (REM) sleep (123.5 +/- 40.1 vs. 101.75 +/- 24.3; p = 0.018) compared with controls. Children with epilepsy had worse attention (CPT index, 10.94 +/- 6.55 vs. 3.42 +/- 4.04; p = 0.004) and exhibited significantly higher CBCL Total Behavior and Internalizing Behavior Problem scales. Whereas regression analysis showed no independent predictors of abnormal behavior and attention, a tendency toward association between CBCL total behavior scale and REM percentage (r= 0.55; p = 0.07), and between CPT overall index and stage 1 sleep percentage (r= 0.40; p = 0.10) was noted.
Conclusions:
Sleep architecture is abnormal in children with primary generalized epilepsy. Further studies are needed to determine whether abnormalities in sleep architecture contribute to poor daytime behavior and attention.
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