The course of sleep habits in newly diagnosed epilepsy in children: A prospective study
Zeynep Vatansever Pınar1, Gunes Sager2, Yakup Çağ3
1Department of Child and Adolescent Psychiatry, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
Insights
Children with epilepsy experience significant sleep problems that improve with anti-seizure medication (ASM) treatment and regular follow-up. Treatment positively impacts sleep habits, reducing issues like bedtime resistance and sleep anxiety.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Clinical Pharmacy
Background:
- Epilepsy and sleep share a complex, bidirectional relationship.
- Epilepsy and its treatments, including anti-seizure medications (ASMs), can negatively impact sleep quality in children.
- Understanding these effects is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate sleep-related problems in children with epilepsy before and after six months of ASM treatment.
- To identify changes in children's sleep habits during epilepsy management.
- To assess the impact of ASMs on sleep across different epilepsy types.
Main Methods:
- A prospective study involving 61 children (aged 4-18) with newly diagnosed epilepsy.
- Children received ASM treatment for six months with regular follow-up.
- The Children's Sleep Habits Questionnaire (CSHQ) was administered pre- and post-treatment.
Main Results:
- Overall CSHQ scores decreased significantly post-treatment, indicating improved sleep.
- Levetiracetam treatment showed significant reductions in bedtime resistance, sleep duration, and sleep anxiety.
- Valproic acid treatment led to decreased sleep duration but an increase in daytime sleepiness.
Conclusions:
- Children with epilepsy exhibit significant pre-treatment sleep disturbances that improve with ASM therapy and consistent follow-up.
- Epilepsy treatment generally positively influences sleep, with notable improvements in various sleep domains.
- Daytime sleepiness may be an exception, warranting further investigation in specific treatment groups.
Background:
Epilepsy and sleep have a close, complex, and reciprocal relationship. Sleep may also be adversely affected by epilepsy and anti-seizure medication (ASM). This study sought to determine sleep-related problems before and after six months of treatment with ASMs follow-up in children with epilepsy, to reveal changes in sleep habits, and to determine the effect of ASMs on sleep in different types of epilepsy.
Methods:
This is a prospective study that included 61 children, aged 4-18 years with newly diagnosed epilepsy, who regularly had follow-up checks and used ASM for six months, and completed the Children's Sleep Habits Questionnaire (CSHQ). Children's Sleep Habits Questionnaire was completed before and after six months of ASM, allowing for assessments based on treatment group and type of epilepsy.
Results:
The mean ages of 61 children were 10.6 ± 3.9 years. The participants' post-treatment total scores on the CSHQ decreased by 2.9 ± 7.8 units on average compared to their pretreatment scores (p = 0.008; p < 0.01). In the levetiracetam group, post-treatment CSHQ subscale scores showed a mean decrease for bedtime resistance (p = 0.001), sleep duration (p = 0.005), sleep anxiety (p = 0.030), and total scores (p = 0.012) (p < 0.05). In the valproic acid group, post-treatment CSHQ subscale scores showed a mean decrease in sleep duration (p = 0.007) and a mean increase in daytime sleepiness (p = 0.03) (p < 0.05).
Conclusion:
Our study found that children diagnosed with epilepsy had significantly higher rates of pretreatment sleep problems, which significantly decreased in patients who regularly attended follow-up examinations and received treatment. Except for the daytime sleepiness factor, our study found that sleep-related problems improved with treatment. It was observed that the initiation of epilepsy treatment had a positive effect on the patient's sleep, regardless of the type of treatment or epilepsy.
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