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Behavioral-educational sleep interventions for pediatric epilepsy: a randomized controlled trial
Shao-Yu Tsai1, Wang-Tso Lee2, Chien-Chang Lee3
1School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Insights
A clinic-based sleep intervention improved sleep quality and quantity in children with epilepsy. The behavioral-educational program showed sustained benefits, though maternal knowledge and sleep quality were unaffected.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Behavioral Intervention
Background:
- Sleep disturbances are common in children with epilepsy.
- Effective interventions are needed to improve sleep in this population.
Purpose of the Study:
- To evaluate a clinic-based, behavioral-educational sleep intervention for children with epilepsy.
- To assess the intervention's impact on children's sleep, maternal knowledge, and maternal sleep quality.
Main Methods:
- 100 children with epilepsy (1.5-6 years) and their parents were randomized to intervention or usual care.
- Objective actigraphy and validated questionnaires assessed sleep outcomes at baseline and 12 months.
- General linear models analyzed changes in outcomes between groups.
Main Results:
- The intervention group showed significantly improved sleep efficiency (2.03%) and total nighttime sleep (16.13 minutes) compared to usual care.
- These improvements were objectively measured by actigraphy.
- No significant effects were found on maternal knowledge or maternal sleep quality.
Conclusions:
- A clinic-based sleep intervention offers significant, measurable, and sustained benefits for sleep in children with epilepsy.
- Further research is needed to explore the impact of improved sleep on quality of life and other functioning.
Study Objectives:
To evaluate the effect of a clinic-based, behavioral-educational sleep intervention on sleep of children with epilepsy, maternal knowledge about childhood sleep, and maternal sleep quality.
Methods:
A total of 100 toddlers and preschool-age children with epilepsy (1.5-6 years, 55% boys) and their parents were randomized to receive sleep intervention (n = 50) or usual care with attention (n = 50). Outcomes were assessed at baseline, 3, 6, and 12 months after intervention with the use of objective actigraphy, Children's Sleep Habits Questionnaire, Parents' Sleep Knowledge Inventory, and Pittsburgh Sleep Quality Index. Intervention effects were examined using general linear models for repeated measurements to compare the mean change in outcomes from baseline to 12 months post-intervention between the two groups.
Results:
Sleep intervention resulted in children having greater sleep efficiency by 2.03% compared with the usual care group (95% CI = 0.20% to 3.86%; p = .03). Children in the intervention group also had significantly longer total nighttime sleep as objectively assessed by actigraphy than did those in the usual care group, with an adjusted mean difference of 16.13 minutes (95% CI = 0.24% to 32.03%; p = .04). No intervention effects were observed for maternal knowledge about childhood sleep, and maternal sleep quality.
Conclusion:
Sleep intervention provided during routine neurologic visits results in significant, measurable, and sustained benefits in sleep quality and quantity in children with epilepsy. Future trials are warranted to evaluate whether improvements in sleep could impact health-related quality of life or other aspects of functioning in children with epilepsy.
Clinical Trial:
This trial has been registered at www.clinicaltrials.gov (trial name: Sleep Intervention for Pediatric Epilepsy; registration number: NCT02514291).
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