Nature and Science of Sleep (Jul 2022)
Sleep Disturbances in Chinese Children with Epilepsy: Associations with Behavioral Problems and Quality of Life
Abstract
Fen Zhao,1,* Xiaoning Sun,2,* Yingyan Wang,1 Yunqing Zhou,1 Yingzhong He,1 Cuijin Wang,1 Feng Han,1 Jie Liu,1 Shao-Yu Tsai,3 Guanghai Wang,2 Jiwen Wang1 1Department of Pediatric Neurology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Paediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 3School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan*These authors contributed equally to this workCorrespondence: Guanghai Wang, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Shanghai, 200127, People’s Republic of China, Email [email protected] Jiwen Wang, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, People’s Republic of China, Email [email protected]: To investigate the association between sleep disturbances and behavioral problems as well as quality of life (QOL) in Chinese children with epilepsy.Methods: Caregivers of 167 epileptic children aged 3 to 12 years completed the Child Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), and the Pediatric Quality of Life Inventory (PedsQL™, 4.0 Core).Results: The prevalence of sleep disturbances (CSHQ total score > 41) in epileptic children was 73.7% [95% CI (66.9%.80.4%)]. Epileptic children with sleep disturbances demonstrated more behavioral problems and lower QOL compared to those without sleep disturbances. Sleep disturbances such as sleep anxiety and daytime sleepiness were associated with more behavioral problems and lower QOL (p < 0.05). Linear regression analyses showed that higher disturbance in sleep duration domain were associated with more behavioral problems, while higher sleep disordered breathing domains was associated with lower QOL (p < 0.05). The interaction between sleep disturbances and behavioral problems in predicting QOL was not significant. The sensitivity analysis using 48 as an alternative cutoff for CSHQ total score obtained consistent results.Conclusion: Sleep disturbances occur frequently among Chinese children with epilepsy, and are associated with more behavioral problems and lower QOL. The sleep disturbance-QOL association is unlikely contingent on behavioral problems. This study highlights the necessity of evaluating and treating sleep disturbances multidimensionally among children with epilepsy to promote their whole health and wellbeing.Keywords: sleep disturbances, behavioral problems, quality of life, epilepsy, children
