Abstract
Background
Sleep comorbidities are common, and sometimes severe, for children with early-life
epilepsies (ELEs). Yet, there is a paucity of data regarding the profile of these
sleep disturbances and their complications.
Methods
Participants registered with the Rare Epilepsy Network (REN) were queried about sleep
via online questionnaires. Descriptive statistics and logistic regression were performed.
Results
Median age of the 356 children was 56 months (interquartile range 30 to 99), 56% were
female, and 53% (188/356) endorsed a sleep concern. Frequent nighttime awakenings
(157 of 350; 45%), difficulty falling asleep (133 of 350; 38%), and very restless
sleep (118 of 345; 34%) were most endorsed. Nocturnal seizures were associated with
sleep concerns and were reported in 75% (268 of 356) of children. Of the children
with nocturnal seizures, 56% (118 of 268) had sleep concerns. Of the children without
nocturnal seizures, 43% (38 of 88) had sleep concerns. Sleep concerns were most common
in dup15q syndrome (16 of 19; 84%). Children aged 4 to ≤10 years (adjusted odds ratio
[aOR] 16.1; 95% confidence interval [CI] 2.0, 131.0) and 10 to <13 years (aOR 22.2;
95% CI 2.6, 188.6) had a greater odds of having a sleep concern compared with children
aged ≤6 months. Female sex appeared protective for sleep concerns (aOR 0.6; 95% CI
0.4, 0.9). The association between sleep concerns and nocturnal seizures was weaker
when adjusted for sex and age category in a logistic regression model.
Conclusions
Reported sleep concerns are highly prevalent in children with ELEs and persist with
age, in contrast to what is expected in healthy children. There may be unmet sleep-related
clinical needs in children with ELEs.
Keywords
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Article info
Publication history
Published online: December 16, 2021
Accepted:
December 10,
2021
Received:
September 10,
2021
Footnotes
This work has neither been published previously, nor is it under consideration for publication elsewhere. The publication of this work is approved by all authors. If accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright holder.
Disclosure of conflicts of interest: Dr. Shellhaas receives research support from NIH (grant 2T32HL110952-06), PCORI, and the Pediatric Epilepsy Research Foundation. She receives royalties from UpToDate for authorship of topics related to neonatal seizures, serves as a consultant for the Epilepsy Study Consortium, and is an associate editor for Neurology and a board member of the Pediatric Epilepsy Research Foundation.
We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
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