Sleep Disturbance Phenotype Trajectories and Associated Multimorbidity in Children With New-Onset Seizures Over 36
Temitayo Oyegbile-Chidi1, Sabrina Tu1, Jordan Eisner2
1Department of Neurology, University of California Davis, Sacramento, California.
Insights
Children with epilepsy may have distinct, persistent sleep disturbance phenotypes. These phenotypes correlate with specific cognitive and behavioral issues, highlighting significant multimorbidity in youth with new-onset epilepsy.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Developmental Psychology
Background:
- Children with epilepsy often experience diverse comorbidities like sleep disturbances, cognitive deficits, and behavioral impairments.
- The heterogeneity suggests potential unique sleep phenotypes in pediatric epilepsy.
- This study investigates distinct sleep phenotypes and their progression in youth with new-onset epilepsy.
Purpose of the Study:
- To identify and characterize sleep phenotypes in children with new-onset epilepsy.
- To examine the progression of these sleep phenotypes over three years.
- To determine the association between sleep phenotypes and cognitive/behavioral profiles.
Main Methods:
- 312 children (6-16 years) with new-onset epilepsy were assessed.
- Sleep disturbances were evaluated using the Sleep Behavior Questionnaire.
- Cognitive and behavioral assessments were conducted at baseline, 18, and 36 months.
Main Results:
- Latent trajectory analysis identified three stable sleep phenotypes: Typical, Moderately Disrupted, and Severely Disrupted.
- The Typical phenotype showed minimal sleep and cognitive/behavioral problems.
- Moderately and Severely Disrupted phenotypes exhibited greater sleep disturbance and higher levels of cognitive/behavioral dysfunction.
Conclusions:
- Sleep disturbance phenotypes in youth with new-onset epilepsy are stable and persistent.
- Distinct sleep phenotypes are linked to unique cognitive and behavioral patterns.
- These findings indicate substantial multimorbidity in this population.
Background:
Children with epilepsy exhibit heterogeneity and variability in comorbidities including sleep disturbance, cognitive dysfunction, and behavioral impairments. This heterogeneity raises the question of whether there are unique sleep phenotypes associated with epilepsy. Here we investigate the presence and progression of sleep phenotypes in youth with new-onset epilepsy over a three-year period and, in addition, characterize their associated cognitive and behavioral profiles to inform the presence and degree of multimorbidity.
Methods:
A total of 312 subjects (aged 6-16 years) were recruited within six weeks of their first recognized seizure. Sleep was evaluated in each child using the Sleep Behavior Questionnaire, assessing five areas of sleep disturbance-bedtime difficulties, parent-child interactions, sleep fragmentation, parasomnia, and daytime drowsiness. Each child also underwent a comprehensive neuropsychologic and behavior assessment. All sleep, cognitive, and behavior measures were evaluated at baseline, 18 months later, and 36 months later.
Results:
Latent trajectory analysis over the 36-month period identified three sleep phenotypes: a sleep phenotype similar to healthy control subjects (Typical Sleep phenotype), a Moderately Disrupted sleep phenotype, and a Severely Disrupted sleep phenotype. The Typical phenotype exhibited the least sleep disturbance overall with the lowest levels of cognitive and behavior problems. The Moderately and Severely Disrupted sleep phenotypes exhibited more sleep disturbance overall and showed the highest levels of associated cognitive and behavioral dysfunction.
Conclusions:
Sleep disturbance phenotypes in youth with new-onset epilepsy are stable and persistent. These distinct phenotypes are also associated with unique cognitive and behavioral patterns-indicating the presence of substantial multimorbidity.
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