Abstracts

Rationale: Sleep-deprived EEGs (SDEEG) are commonly used in clinical practice to detect sleep-induced epileptiform abnormalities, which are diagnostic indicators of specific types of epilepsy. While this is a very useful diagnostic technique, studies have shown that the SDEEG places a notable burden on both parents and children. One study reported that nearly fifty percent of parents found it difficult to keep their child awake at night and thirty percent of parents found it difficult to wake their child in the morning (1). Objective: To prospectively study the specific strategies used by parents and/or children to ensure sleep deprivation before undergoing a SDEEG. The findings of this study will be used to provide guidance for parents and children on how to adopt a convenient method of sleep deprivation. Methods: Inclusion Criteria: 1) Children between 1-17 years who either had seizures or were suspected to have seizures. 2) Male and female participants were included, with no restrictions based on race or ethnic origin. Children referred from the neurology and general pediatrics outpatient clinics at McMaster Children s Hospital for a SDEEG during May 2008 ongoing, fulfilling the inclusion criteria, were studied. All participants were interviewed by either an EEG technologist or co-investigator and were administered a qualitative questionnaire. The questionnaire collected data about the patient s demographic details, previous EEG history, and sleep-deprivation strategies. The data collected was analyzed for trends and main themes. Results: 93 patients (aged 16mos-17 yrs; mean 8.32 yrs) were interviewed (Table 1), to date. 82.8% of children had a previous EEG, with 24.7% of all patients having had a previous SDEEG. Main themes identified for the patients were: 1) Instruction on amount of sleep deprivation; 52.7% of the patients were instructed on how many hours their child should sleep; 2) Parents reactions to SDEEG; Will my child fall asleep during EEG? was the most common reaction (59.1%) and I do not want to keep myself awake was the least common (14.0%); 3) Strategies used to keep child awake at night; most common strategy (77.4%) was to watch TV; 4) Strategies used to keep child awake on trip to the hospital on the day of SDEEG; most common strategy (68.8%) was to constantly talk to child in the vehicle; 5) Success of strategies; 90.3% of children did not fall asleep on the trip to the hospital. Conclusions: Certain sleep-deprivation strategies appear to be used across all seasonal and age-specific subgroups (watching TV, playing computer/video games, constantly talking). Indoor activities are largely preferred over outdoor activities, across all seasons. Outdoor activities for sleep-deprivation are most preferred during the summer months. Similarly, parents, across all patient age groups, are primarily concerned with whether their child will fall asleep during the SDEEG. The data collected can be used to help parents and children better cope with sleep-deprivation before SDEEG and to lessen their anxiety regarding adequate sleep deprivation.