Abstracts

People with epilepsy commonly have sleep complaints. Seizures, antiepileptic drugs, and comorbid sleep disorders may result in sleep problems and excessive daytime sleepiness. While it is well-known that sleep problems are associated with behavior problems in the general population, few studies have examined this relationship in children with epilepsy where behavior problems are known to be elevated. This study used parent completed behavior rating measures and a structured parent interview to examine sleep disturbance in children with epilepsy and the consequences for daytime behavior. Participants included 81 children recruited from two major health care systems in Wisconsin; 46 with epilepsy (localization-related=29, primary generalized=17) and 35 age-matched controls (1st degree cousins). Average age of the sample was 12.8 years (range 7.9-18). Parents underwent structured interview using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and completed the Achenbach Child Behavior Checklist (CBCL) and the Behavior Rating Inventory of Executive Function (BRIEF). Sleep disorder items were extracted from the K-SADS and CBCL and related to global measures of executive and behavioral function. Mean comparison of parent reports indicated that children with epilepsy exhibited more sleep problems than controls. Three of 4 CBCL sleep items were significantly different between groups (sleep more, sleep less, problems sleeping), and K-SADS responses indicated more problems with hypersomnia in children with epilepsy (p[lt].05). There were no significant differences in reported sleep problems between epilepsy syndromes or AED status. CBCL Total Problems and the Global Executive Composite from the BRIEF were significantly elevated (worse) in children with epilepsy, and for both patients and controls, children with sleep problems had significantly more behavior problems (CBCL and BRIEF, p[lt].05). Analysis of covariance indicated that sleep problems on both the CBCL and KSADS remained a significant predictor of self-regulation problems (BRIEF) when epilepsy group was controlled (p=.02). Parents of children with new onset epilepsy report significantly elevated rates of sleep problems compared to age and gender matched controls, regardless of epilepsy syndrome or whether child is taking AEDs. Sleep problems are associated with behavior and self-regulation problems in both patients and controls. These findings suggest that sleep problems may be a moderating variable in the study of the relationship between epilepsy and behavior. (Supported by NIH NS R01-44351, F32 MH649882, and MO1 RR03186 (GCRC).)