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Sleep disturbance in pediatric intracranial hypertension
Alexandra B Kornbluh1, Katherine Thompson2, Gada Mcmahen1
1Department of Neurology, Nationwide Children's Hospital, Columbus, Ohio.
Insights
Children with intracranial hypertension experience more sleep disturbances, including issues with falling asleep and breathing problems during sleep. This study highlights a link between this condition and altered sleep patterns in pediatric patients.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Ophthalmology
Background:
- A known link exists between headache disorders and sleep disturbances in children.
- The relationship between sleep disturbance and pediatric intracranial hypertension (IH) remains unclear.
Purpose of the Study:
- To investigate the association between sleep issues and pediatric intracranial hypertension.
- To compare sleep behaviors in children with IH to their healthy siblings.
Main Methods:
- A cohort of pediatric IH patients was compared with matched sibling controls.
- Sleep habits were assessed using the Children's Sleep Habits Questionnaire.
- Statistical analyses included paired t tests to compare patient and control groups.
Main Results:
- Patients with pediatric IH showed significantly higher total sleep disturbance scores compared to controls.
- Specific sleep disturbances, including sleep onset delay, parasomnias, and sleep-disordered breathing, were more prevalent in children with IH.
- No significant differences in other sleep subscales or between patient subsets were observed.
Conclusions:
- Pediatric intracranial hypertension is associated with a modest increase in sleep disturbances.
- Sleep issues may be a contributing factor or consequence of pediatric IH.
- Further research is warranted to explore the causal relationship and clinical implications.
Study Objectives:
There is a well-established association between headache disorders and sleep disturbances in children, but it is unknown whether sleep disturbance plays a role in pediatric intracranial hypertension. The objective of this study was to examine sleep issues related to pediatric intracranial hypertension.
Methods:
Patients with intracranial hypertension in the Pediatric Intracranial Hypertension Clinic were recruited between July 2017 and September 2018. Demographic data were collected from the electronic medical record in addition to patient and parent completed questionnaires. Information on sleep behaviors was gathered using the Children's Sleep Habits Questionnaire, and control data were obtained from patient siblings. Statistical analyses were performed using paired t tests or two-sample t tests, as appropriate.
Results:
Sixty-two pairs of patients and matched sibling controls were compared. We found a statistically significant difference in total sleep disturbance score (control mean, 44.3; patient mean, 48.1; n = 33 pairs, t = -2.2, P = .035), as well as subscale scores of sleep onset delay (control mean, 1.4; patient mean, 1.7; n = 52 pairs, t = -2.53, P = .014), parasomnias (control mean, 8.5; patient mean, 9.5; n = 42 pairs, t = -2.59, P = .013), and sleep-disordered breathing (control mean, 3.1; patient mean, 3.4; n = 44 pairs, t = -2.61, P = .013). No difference was found in bedtime resistance, sleep duration, sleep anxiety, night awakenings, and daytime sleepiness subscales. Furthermore, no difference was found in total sleep disturbance score between patient subsets, including primary vs secondary intracranial hypertension, body mass index, pubertal status, presence of headaches, or intracranial hypertension treatment.
Conclusions:
This observational study suggests that pediatric intracranial hypertension is associated with a modest increase in sleep disturbances.
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