HomeThe PCMC Journalvol. 20 no. 1 (2024)

Sleep disturbances among 4- to 12-year-old Filipino children with drug resistant epilepsy in a pediatric tertiary hospital

Cherise Andrea E Llaneta | Mel Michel Villaluz

Discipline: medicine by specialism

 

Abstract:

Objectives: To perform a pilot study on the frequency of sleep-disturbance (Total sleep Disturbance Score (TSD) of > 41) in children diagnosed with Drug Resistant Epilepsy aged 4 to 12 years, using the Children’s Sleep Habits Questionnaire (CSHQ). Methodology: The Children’s Sleep Habits Questionnaire (CSHQ) was used to screen for sleep disturbances among 73 patients aged 4 to 12 years old with drug-resistant epilepsy seen at the Seizure Clinic of Philippine Children’s Medical Center. Descriptive statistics were used to characterize sociodemographic variables, and sleep and epilepsy-related variables. Continuous data were presented as mean ± standard deviation (SD), and categorical data as frequencies (percentages). Results: Sleep disturbances were common and severe in children with drug-resistant epilepsy. Out of the seventy-three participants, 61 patients had a TSD score of greater than 41 (84%) and 12 (16%) had TSD scores below 41 with a mean CSHQ score of 58. The most frequently occurring sleep disturbances involve the domains of bedtime resistance (29%), night wakings (28%), and daytime sleepiness (23%). Meanwhile, the least frequently occurring sleep disturbances involve the domains of sleep disordered breathing (76%), parasomnias (65%), and sleep anxiety (56%). Conclusion: Majority of the children with drug-resistant epilepsy are sleep disturbed exhibiting high TSD scores (>41) using the Children’s Sleep Habits Questionnaire. We recommend to actively evaluate and screen for sleep and behavioral problems concurrently in children with epilepsy.



References:

  1. Owens, J. A., Spirito, A., & McGuinn, M. (2000). The children’s sleep habits questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043-1051.
  2. Mindell JA & Owens JA (2003). A clinical guide to pediatric sleep: diagnosis and management of sleep problems. XPhiladelphia: Lippincott, Williams &Wilkins.
  3. Mindell, J. A., Kuhn, B., Lewin, D. S., Meltzer, L., & Sadeh, A. (2006). Behavioral treatment of bedtime problems and night wakings in infants and young children. SLEEP, 29(10).
  4. Zhao, F., Sun, X., Wang, Y., Zhou, Y., He, Y., Wang, C., Han, F., Liu, J., Tsai, S.-Y., Wang, G., & Wang, J. (2022). Sleep disturbances in Chinese children with epilepsy: Associations with behavioral problems and quality of life. Nature and Science of Sleep, Volume 14, 1225–1236. https://doi.org/10.2147/nss.s367900
  5. Tang, H Liu, Z., Wang, G.,., Wen, F., & Li, N. (2014, July). Reliability and validity of the Children’s Sleep Habits Questionnaire in preschool-aged Chinese children. Sleep and Biological Rhythms, 12(3), 187–193. https://doi.org/10.1111/sbr.12061
  6. Mabilangan, K. & Moral-Valencia, M.A. (2015). Validation study of the Filipino version of the          Children’s Sleep Habits Questionnaire. Sleep Medicine, 16, S61-62.
  7. Kharod P, Mishra D, Juneja M. Drug-resistant epilepsy in Indian children at a tertiary-care public hospital. 2019:5-8.
  8. Reddy DS, Thompson W, Calderara G. Molecular mechanisms of sex differences in epilepsy and seizure susceptibility in chemical, genetic and acquired epileptogenesis. Neurosci Lett. 2021 Apr 17;750:135753. doi: 10.1016/j.neulet.2021.135753. Epub 2021 Feb 18. PMID: 33610673; PMCID: PMC7994197.
  9. Foldvary-Schaefer NR, Waters TE. Sleep-Disordered Breathing. Continuum (Minneap Minn). 2017 Aug;23(4, Sleep Neurology):1093-1116. doi: 10.1212/01.CON.0000522245.13784.f6. PMID: 28777178.
  10. Batista BH, Nunes ML. Evaluation of sleep habits in children with epilepsy. Epilepsy Behav. 2007 Aug;11(1):60-4. doi: 10.1016/j.yebeh.2007.03.016. Epub 2007 May 11. PMID: 17499554.
  11. Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. J Clin Sleep Med. 2016 Nov 15;12(11):1549-1561. doi: 10.5664/jcsm.6288. PMID: 27707447; PMCID: PMC5078711.
  12. Chan B, Cheong EY, Ng SF, Chan YC, Lee QU, Chan KY. Evaluation of sleep disturbances in children with epilepsy: a questionnaire-based case-control study. Epilepsy Behav. 2011 Aug;21(4):437-40. doi: 10.1016/j.yebeh.2011.05.007. Epub 2011 Jun 24. PMID: 21704566.
  13. Bill F, Foundation MG. Global , regional , and national burden of epilepsy , 1990 – 2016 : a systematic analysis for the Global Burden of Disease Study 2016. 2019. doi:10.1016/S1474-4422(18)30454-X
  14. Carter, K., Hathaway, N., & Lettieri, C. (2014). Common sleep disorders in children. Am Fam Physician, 89(5):368-377
  15. Gavino M. & Pacifico, R. (2008). Sleep patterns of patients ages 4-12 with pervasive developmental disorder enrolled at the neurodevelopmental center in a Tertiary Teaching Hospital. (Unpublished).
  16. Gutter, T., Brouwer, O. F., & de Weerd, A. W. (2013). Subjective sleep disturbances in children with partial epilepsy and their effects on quality of life. Epilepsy & Behavior, 28(3), 481–488. https://doi.org/10.1016/j.yebeh.2013.06.022
  17. Khalil M. Risk Factors for Intractable Epilepsy in Children Risk Factors for Intractable Epilepsy in Children. 2018;(April). doi:10.12816/0038475
  18. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE OFFICIAL REPORT A practical clinical definition of epilepsy. 2014:475-482. doi:10.1111/epi.12550
  19. Madulara, G. (2017) A Survey On Sleep Behaviors And Sleep-Related Problems Among Asthmatic Children Ages 6 – 12 Years Old In University of Santo Tomas Hospital – Outpatient Division Using The Filipino Version Of The Children’s Sleep Habits Questionnaire (CSHQ) https://www.em-consulte.com/article/1200291/article/a-survey-on-sleep-behaviors-and-sleep-related-prob
  20. Pedraza AJD, Cerdá JMM. Drug-resistant epilepsy: Definition and treatment alternatives. 2015;30(7). doi:10.1016/j.nrleng.2014.04.002
  21. Tigistu M, Azale T, Kebebe H, Yihunie T. Frequency of seizure attack and associated factors among patients with epilepsy at University of Gondar Referral Hospital: A cross-sectional study, Gondar, North West Ethiopia, 2017. BMC Res Notes. 2018;11(1):2-7. doi:10.1186/s13104-018-3761-3
  22. Tsui, S.-Y., Lee, W.-T., Lee, C.-C., & Weng, W. C. (2018). Sleep and Behavior Problems in Children With Epilepsy. https://doi.org/https://doi.org/10.1016/j.pedhc.2018.07.004
  23. Viteva, E. I. (2014). Seizure frequency and severity: How really important are they for the quality of life of patients with refractory epilepsy. Annals of Indian Academy of Neurology, 17(1), 35. https://doi.org/10.4103/0972-2327.128544