Spectrum of polysomnographic abnormalities in children with epilepsy
Joseph Kaleyias1, Marcos Cruz, Jatinder S Goraya
1Section of Neurology, Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Insights
Children with epilepsy often experience sleep problems, including snoring and sleep-disordered breathing like obstructive sleep apnea syndrome. Poor seizure control is linked to worse sleep quality.
Area of Science:
- Neurology
- Sleep Medicine
- Pediatrics
Background:
- Epilepsy in children is frequently associated with sleep disturbances.
- Polysomnography is crucial for diagnosing sleep abnormalities in this population.
Purpose of the Study:
- To evaluate polysomnographic abnormalities in children with epilepsy and sleep complaints.
- To compare sleep characteristics between children with epilepsy and obstructive sleep apnea syndrome (OSAS) versus those with uncomplicated OSAS.
Main Methods:
- Retrospective analysis of polysomnography data from 40 children with epilepsy.
- Assessment of sleep variables, antiepileptic drugs, epilepsy type, and seizure control.
- Comparison of subgroups with epilepsy and OSAS versus uncomplicated OSAS.
Main Results:
- 83% of children with epilepsy exhibited snoring, sleep-disordered breathing, or periodic limb movements of sleep.
- Poor seizure control correlated with lower sleep efficiency, higher arousal index, and increased REM sleep.
- Children with epilepsy and OSAS had higher BMI, longer sleep latency, higher arousal index, and more severe desaturation compared to those with uncomplicated OSAS.
Conclusions:
- Sleep-disordered breathing, including OSAS, is prevalent in children with epilepsy presenting with sleep issues.
- Seizure control significantly impacts sleep quality in epileptic children.
- Epilepsy complicates OSAS, leading to distinct polysomnographic findings and increased desaturation severity.
Abstract:
This study sought to evaluate polysomnographic abnormalities in a cohort of 40 children with epilepsy who underwent a sleep study because of various sleep complaints. Retrospective analyses included polysomnographic variables, antiepileptic drugs, type of epilepsy, and seizure control. The subgroup with epilepsy and obstructive sleep apnea syndrome was compared with 11 children who manifested uncomplicated obstructive sleep apnea syndrome. Thirty-three patients (83%) exhibited snoring (42.5%), sleep-disordered breathing (obstructive hypoventilation, 12.5%; obstructive sleep apnea, 20%; and upper-airway resistance syndrome, 7.5%), or periodic limb movements of sleep (10%). Children with poor seizure control demonstrated significantly lower sleep efficiency, a higher arousal index, and a higher percentage of rapid-eye-movement sleep compared with children who were seizure-free or exhibited good seizure control. Patients with epilepsy and obstructive sleep apnea had significantly a higher body mass index, longer sleep latency, a higher arousal index, and a lower apnea-hypopnea index, but significantly more severe desaturation compared with patients with uncomplicated obstructive sleep apnea. A significant proportion of children with epilepsy referred for polysomnography with diverse sleep problems manifest sleep-disordered breathing, including obstructive sleep apnea syndrome.
Related Concept Videos
01:22Epilepsy ll: Types
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:20Seizures l: Introduction
01:19Seizures ll: Types
01:23Brain Waves