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G329(P) Prevalence of symptoms of disordered sleep in children with epilepsy
  1. OO Kehinde1,
  2. AE McLellan1,
  3. DS Urquhart2
  1. 1Paediatric Neurology, Royal Hospital for Sick Children, Edinburgh, UK
  2. 2Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK

Abstract

Aim To define prevalence of sleep-related breathing disorder (SRBD) as measured by Paediatric Sleep Questionnaire (PSQ) and Excessive Daytime Sleepiness (EDS) as measured by modified Epworth sleepiness scale (ESS) in a cohort of children with epilepsy compared with healthy controls.

Methods Consecutive epileptic children attending for overnight video telemetry or outpatient clinics were recruited along with non-epileptic controls from paediatric surgical clinics in a tertiary children hospital setting. Additional information was collected on use of anti-epileptic drugs (AED). Those with additional neurological or respiratory problems were excluded. Parents were asked to complete both PSQ and modified ESS on behalf of their children. A score of >0.33 on the PSQ-SRBD scale was considered abnormal, and scores of >10 on the ESS were considered significant. Data were entered into Microsoft Excel database and analysed using SPSS v19.0. Non-parametric statistical comparison was made between groups by Mann-Whitney U-test (MWU).

Results Seventy-five children were studied, 33 of whom had a diagnosis of epilepsy median (IQR) age 9 (5–12) years, along with 42 controls of median (IQR) age 6 (4–8.5) years. 49% epileptic subjects had an abnormal PSQ-SRBD score compared with 5% controls. The median (IQR) PSQ-SRBD score in the epilepsy group was 0.36 (0.22 to 0.46) versus 0.17 (0.09 to 0.23) in controls (p < 0.001, MWU). PSQ sub-scale scores were also significantly higher for snoring (p = 0.04), daytime sleepiness (p < 0.001), and inattention/behaviour (p = 0.007) in the epilepsy group compared with controls. Additionally, 30% epileptic subjects had an ESS >10 compared with 5% controls. Median (IQR) ESS score in epileptic subjects was 5 (1 to 10) versus 1 (0–3.25) in controls (p = 0.001, MWU). Within epileptic subjects, PSQ-SRDB (but not sub-scale scores) and ESS were higher in those on AED (p = 0.001 and p = 0.48 respectively).

Conclusion This study suggests a higher prevalence of symptoms of SRBD and EDS in children with epilepsy compared with healthy children. Anti-convulsant therapy may be a confounding factor, but does not alone account for the associations seen. Further studies which should include polysomnography to verify the presence (rather than suggestion by questionnaire) of SRBD are warranted.

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