Abstracts

To determine if epileptic children have a greater incidence of sleep problems than their non-epileptic siblings and to identify which epilepsy-specific factors correlate with greatest risk. Case-control study of children aged 6-18 years. Cases had at least a one year history of epilepsy and were followed in the Pediatric Neurology or Refractory Epilepsy clinics at the Alberta Childrens Hospital between 15/09/03 and 15/04/04. All cases had a non-epileptic sibling in the same age group who acted as a control. The parent or caregiver was asked to complete a Sleep Behavior Questionnaire (SBQ) and Child Behavior Checklist-6-18 (CBCL) for each child. Specific details regarding the cases epilepsy including seizure type and frequency, antiepileptic drug treatment, prior epilepsy surgery or ketogenic diet use, cognitive status, seizure timing (nocturnal vs. diurnal), etiology, family history of epilepsy and EEG findings (background, location of discharge, activation with sleep) were recorded from chart review. Total and subscale scores on the SBQ and CBCL were compared between cases and controls. Forty cases with sibling controls were recruited (20 M and 20 F in each group). Mean age for cases was 10.6 yrs (range 6-16) and for controls was 11.2 yrs (range 6-16). Epilepsy type was idiopathic generalized in 5, symptomatic generalized in 7 and partial in 28 (13 lesional). Twenty-two cases had mental handicap. Fourteen cases were refractory, having failed three or more AEDs and having seizures at least q3monthly. With the exception of the Bedtime Difficulties subscale, all other subscales and the total score on the SBQ were significantly higher in cases with epilepsy than non-epileptic controls (sleep latency, parent-child interaction during the night, sleep fragmentation, parasomnias, daytime drowsiness and total score, all p[lt]0.004). In cases, those with refractory epilepsy and cognitive delay had highest scores (p[lt]0.02 for both). Cases with epilepsy also had significantly higher scores than controls on most of the CBCL subscales (Withdrawn/Depressed, Somatic complaints, Social problems, Thought problems, Attention problems, Aggressive behavior, all p[lt]0.02) however higher total SBQ score did not correlate with problems on the CBCL. Cases with mental handicap scored significantly higher in the Withdrawn/Depressed, Social problems, Thought problems and Attention problems subscales than cases with normal IQ (all p[lt]0.005). Cases with refractory epilepsy had greater Attention problems than non-refractory cases. Sleep difficulties are significantly more common in children with epilepsy than their non-epileptic siblings. Children with refractory epilepsy and those with cognitive delay appear at highest risk. Although cases also demonstrated greater problematic behavior on the CBCL, these difficulties did not appear to correlate with greater sleep disruption.