Sleep Related Breathing Disorders In Children With Epilepsy

OBJECTIVE: Sleep-related breathing disorders (SRBD) may influence epilepsy and adult literature shows that fragmented sleep has negative impact on quality of life, seizure control and drug responsiveness. Limited literature on the impact of SRBD on children with epilepsy (CWE) prompted us to study their prevalence in this population and assess if they impact drug responsiveness. METHODS: This observational study enrolled 238 children with epilepsy (CWE) of 2-12 years from the Pediatric epilepsy clinic of a tertiary facility. 119 children with drug responsive and 119 with drug refractory epilepsy (DRE) were enrolled over an eleven-month period according to pre-defined inclusion and exclusion criteria. A validated paediatrics sleep questionnaire (PSQ) was applied in all and a score of more than 8/22 was considered abnormal. The data was analyzed using chi square or Fisher’s exact test (as applicable) and correlation between two variables was performed using Spearman’s correlation test. A P-value of less than 0.05 was considered significant. RESULTS: 44.5% of CWE had SRBD by the PSQ. 58% of DRE and 31% of drug responsive epilepsy had symptoms of SRBD. SRBD was found significantly higher (P<0.0001) in patients with drug refractoriness. No significant association was found with demographic variables, family history and age of onset. CONCLUSIONS: SRBD has high prevalence in CWE compared to normal historic controls and has significant association with drug refractoriness. It’s imperative that all CWE especially drug refractory are screened, confirmed and treated for SRBDs. Further studies should be undertaken to evaluate the benefit of treating SRBD on epileps.