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Physically active children with epilepsy have good objective sleep duration and efficiency despite subjective reports
Jeffrey Do1, Richard J Webster2, Patricia E Longmuir1
1Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Insights
Children with epilepsy showed normal sleep patterns and activity levels, similar to their peers. An exercise intervention did not significantly alter sleep or psychosocial well-being, though less active children increased their physical activity.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Exercise Science
Background:
- Children with epilepsy often experience sleep disturbances and psychosocial challenges.
- Understanding the interplay between physical activity, sleep quality, and well-being in this population is crucial.
Purpose of the Study:
- To longitudinally assess objective and subjective sleep quality in children with epilepsy.
- To investigate the relationship between increased physical activity and sleep and psychosocial well-being.
- To evaluate the impact of a 12-week exercise intervention on these measures.
Main Methods:
- 22 children (aged 8-14) with epilepsy wore pedometers for activity and sleep tracking.
- Baseline and post-intervention assessments included epilepsy severity (E-Chess), sleep habits (CSHQ), quality of life (KIDSCREEN-27, PedsQL™), fatigue (PedsQL™), depression (CDI-S), and anxiety (MAS-C).
- A 12-week exercise counseling intervention was implemented.
Main Results:
- Children with epilepsy demonstrated comparable physical activity levels (11,271 steps/day) and sleep efficiency (87.4%) to peers.
- The exercise intervention did not significantly change objective sleep, quality of life, fatigue, depression, or anxiety.
- Subjective sleep quality showed a marginal improvement (p=0.05).
- Older children and those less active at baseline were more likely to increase activity.
Conclusions:
- Children with epilepsy, particularly those as active as their peers, exhibit good objective sleep despite potential subjective complaints.
- An exercise counseling intervention may benefit less active or older children with epilepsy by increasing physical activity.
- Further research is needed to explore targeted interventions for sleep and psychosocial well-being in pediatric epilepsy.
Objective:
The aim of this study was to longitudinally characterize in children with epilepsy the objective and subjective sleep quality and the relationship between increased physical activity and sleep as well as measures of psychosocial well-being.
Methods:
Baseline physical activity and sleep were established in children with epilepsy over four weeks, prior to a 12-week exercise intervention (weekly meeting with exercise counselor). Participants continuously wore a wrist pedometer (Fitbit Flex®) to capture daily number of steps, sleep efficiency, and total sleep time. The Early Childhood Epilepsy Severity Scale (E-Chess) assessed baseline epilepsy severity. Subjective sleep quality (Children's Sleep Habits Questionnaire, CSHQ), quality of life (KIDSCREEN-27; Pediatric Quality of Life Inventory, PedsQL™, 4.0 Core), fatigue (PedsQL™ Multidimensional Fatigue Scale), depression (Children's Depression Inventory-Short), and anxiety (Multidimensional Anxiety Scale for Children) were assessed pre- and post-interventions.
Results:
Our cohort of 22 children with epilepsy aged 8-14 years was similarly active to peers (11,271 ± 3189 mean steps per day) and displayed normal sleeping patterns (mean sleep efficiency: 87.4% ± 3.08 and mean total sleep time: 521 ± 30.4). Epilepsy severity assessed by E-Chess was low to moderate (median baseline E-Chess score of 6, interquartile range: 5-7). Study outcomes did not change with the intervention. Older children and those with lower baseline activity were more likely to increase their activity during the intervention. Changes in physical activity were not associated with changes in sleep outcomes when accounting for age, sex, and baseline E-Chess score. Subjective sleep quality marginally improved with the intervention (CSHQ total score: 44.5 ± 5.8 at baseline and 41.6 ± 7.2 at the end of study, p = 0.05). Quality of life, fatigue, depression, and anxiety did not change with the intervention (p = 0.55, 0.60, 0.12, and 0.69, respectively).
Significance:
Children with epilepsy who are as active as peers without epilepsy have good objective measures of sleep despite self-reported fatigue and parent-reported sleep problems. The physical activity of initially less active and older children with epilepsy may benefit from an exercise counseling intervention.
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