Abstracts

Children with epilepsy are reported to have frequent sleep disturbances including sleep fragmentation, and excessive daytime drowsiness. Epilepsy is known to affect a child[apos]s cognitive, social, and appears to have important secondary effects on sleep. Seizure disorders can affect both the quality and architecture of sleep and interictal discharges may also cause sleep disruption and affect normal progression through sleep stages .Most of these previous studies reportsed only small series of children undergoing overnight polysomnography(PSG). The objective of this study was to objectively measure sleep architecture and sleep disturbance in a large number of children with epilepsy A retrospective chart review was carried out of consecutive children with epilepsy who were referred to our center[apos]s sleep laboratory for a PSG study between 1998-2004. The data abstracted included epilepsy syndrome and results of the PSG. PSG results were compared to age-matched normative data. The children were referred by their neurologist to evaluate different sleep complaints of the child or the parent/caregiver. Children who had evidence of sleep disordered breathing on the polysomnography were excluded to focus on the changes in sleep caused by the child[apos]s seizures, interictal discharges or antiepileptic medications. Children were also excluded if there had been a change in antiepileptic medication within one month prior to the sleep study due to the possible sedating effect of the medication change. 54 children were identified. The children were divided into two groups, primary generalized and partial epilepsy. There were 21of children with primary generalized and 33 with partial epilepsy. The ages was 1-17 years. Significant differences were found for sleep efficiency (time asleep/time in bed) and amount of rapid eye movement (REM) sleep. There were no significant difference in NREM sleep. The average sleep efficiency for all children irrespective of epilepsy type was low compared to normative data ( p=0.0005) Comparing the two groups, the average sleep efficiency was lower in the children with generalized epilepsy. The average percentage of time spent in REM sleep was decreased for children in both groups. The results in this study which used overnight polysomnography as an objective measure of sleep demonstrates changes in sleep architecture in children with primary generalized and partial epilepsy. These changes were independent of sleep related breathing disorder (which will cause additional problems if present) as these children were excluded from the analysis. As children were on a variety of AED combinations, the influence of individual medications could not be evaluated. These results demonstrate the importance of evaluating sleep in children with epilepsy as it is established that poor sleep will exacerbate seizures. Further research regarding the evaluation of sleep disorders, disrupted sleep architecture and the treatment of these problems is warranted.