Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity
Berit Hjelde Hansen1, Kristin Å Alfstad2, Betty van Roy3
1Division of Mental Health, Akershus University Hospital, Lørenskog, Norway.
Insights
Psychiatric comorbidity significantly impacts sleep problems in children and adolescents with epilepsy. Addressing these mental health conditions may improve sleep quality and overall well-being in this population.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Sleep Medicine
Background:
- Sleep disturbances are prevalent in pediatric epilepsy, affecting seizure control, daily function, and quality of life.
- Understanding the factors contributing to sleep issues is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the association between psychiatric comorbidity and sleep problems in children and adolescents with epilepsy.
- To differentiate between parent-reported and self-reported sleep issues in relation to mental health conditions.
Main Methods:
- A sample of 94 children and adolescents (10-19 years) with epilepsy was assessed.
- Sleep problems were evaluated using the Children's Sleep Habit Questionnaire (CSHQ) and Sleep Self-Report (SSR).
- Psychiatric diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL).
Main Results:
- Children and adolescents with epilepsy reported high levels of sleep problems compared to population norms.
- A significant association was found between psychiatric disorders and elevated scores on both CSHQ and SSR.
- These associations persisted after adjusting for epilepsy-specific variables, except for parent-reported parasomnias.
Conclusions:
- Psychiatric comorbidity is a significant factor contributing to sleep problems in pediatric epilepsy.
- Approximately one-third of the variance in reported sleep problems can be attributed to psychiatric comorbidity.
- Targeting psychiatric conditions may be a key strategy to improve sleep in children with epilepsy.
Abstract:
Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy.
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