Abstracts

Sleep disturbances occur more frequently in children with epilepsy and are associated with daytime behavior problems including hyperactivity, inattention, and opposition (Carney and Kohrman, 2003). We have previously reported at least 80 percent of a sample of children with epilepsy have some form of physiologic sleep disturbance, such as abnormal sleep architecture and sleep disordered breathing, as measured by polysomnogram (PSG; Becker et al., 2004). Further, over 50 percent of these children had behavior problems including inattention, hyperactivity and/or oppositional behaviors (Becker et al. 2003). Although the exact relationship between sleep disturbance and problem behavior in children with epilepsy is unclear, it has been suggested that behavior problems may be related to daytime sleepiness. In a preliminary descriptive analysis of this hypothesis, we examined sleepiness in 30 children with epilepsy and reported sleep complaints (ages 7-14 yrs). The children were divided into three groups based upon parent report of inattentiveness/hyperactivity and problem behavior, as reported on the Conners[apos] Parent Rating Scale-Revised: Long Version (CPRS-R:L) and the Eyberg Child Behavior Inventory (ECBI): 1) clinically significant behavior problems, 2) subclinical behavior problems, and 3) behavior within normal limits. All 30 children underwent overnight PSG during which sleep latency, the interval of time between [quot]going to bed[rdquo] and the onset of sleep, was recorded. Increased sleepiness is associated with decreased sleep latency. As can be seen in Table 1, sleep latency in all groups was relatively long and not suggestive of significant sleepiness. However, the rapidness of sleep onset did vary by degree of behavior problems, such that children with epilepsy who had clinically elevated inattention/hyperactivity and/or clinically elevated oppositionality fell asleep more quickly than children with epilepsy whose behavior was within normal limits. While further comparative analyses could not be completed due to small sample sizes across groups, these initial findings suggest that the level of sleepiness in children with epilepsy may be an important factor in daytime behavior problems. Additional research is needed to further explore this relationship and to examine the specific role of underlying sleep disturbances in children with epilepsy and comorbid behavior problems. If such a relationship is confirmed, it suggests that decreasing daytime sleepiness by treating sleep disturbances in children with epilepsy could lead to improvements in daytime behavior.[table1][table2] (Supported by EFA Student Fellowship.)