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Solving sleep problems helps children with epilepsy - study

5 April, 2005

Problems with
their sleeping habits may explain why children with epilepsy are often
hyperactive, according to a study undertaken at the University of Florida's Evelyn F and William L McKnight Brain Institute.

Epilepsy has long been thought to cause excitability and contrariness in children, the researchers said, writing in the journal Epilepsy & Behavior.
However, they now think that the real reason some of these children
cannot sit still or pay attention is because of a lack of sleep.

The
study monitored the brain and muscular activity of 30 children with
epilepsy between the ages of seven and 14 during single overnight
stays. None of the children had seizures, but some awoke hundreds of
times because of breathing problems.

Seventy-three
per cent of the children studied (22 of the 30) met clinical criteria
for inattention or hyperactivity. Of these 22 children, each had a
sleep disorder, 14 had problems paying attention during the day and
eight had hyperactive symptoms, supporting the idea that a poor night's
sleep is associated with children's daytime attention problems.

In
all, 24 of the children (80 per cent) breathed shallowly or had
breathing disruptions caused by apneas (a temporary stopping of
breathing), which usually happens when the soft tissue in the rear of
the throat relaxes during sleep and blocks a person's airway.

As
the breathing disruptions increased in duration, the children spent
less time in rapid eye movement (REM) sleep, a period in the sleep
cycle when brain activity is highest and people dream intensely. The
children in the study spent 17 per cent of total sleep time in the REM
stage, whilst the normal for young adults is 25 per cent.

Dr Paul Carney, chief of paediatric neurology at the university's college of medicine, said:

"When
we treated kids with sleep disturbances, not only did their epilepsy
get better, their daytime behaviour, concentration and capacity to
learn increased. Many kids with epilepsy aren't being adequately
assessed for underlying sleep disorders. We can significantly have an
impact over their cognition, learning and maybe even improve their
epilepsy by improving their sleep."

"Removing
the sleep problem does seem to improve the behaviour problem
significantly, because it changes the child's level of alertness,
commonly, adults are just not as awake if they have a sleep disorder.
But children who haven't taken their nap are wound up instead. Treating
their sleep disorder, we think, can enable their brain to have some
control over unwanted behaviour."

The
researchers found no correlation between seizure frequency and
behavioural problems. Epilepsy alone did not appear to predispose them
to behavioural problems.

Research
with different groups of children is now under way to determine whether
treatment of sleep disorders will reduce seizure frequency and
severity, and to more fully understand the effects of sleep disorders
on children's behavior and cognitive abilities. A tonsillectomy is a
common treatment for sleep apneas in children.