Department of Pediatric Neurology, Faculty of Medicine, Inönü University, Malatya, Turkey.
Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inönü University, Malatya, Turkey.
Epilepsy Behav. 2023 Dec;149:109493. doi: 10.1016/j.yebeh.2023.109493. Epub 2023 Nov 21.
This study aimed to evaluate the relationship between sleep disturbances in children with epilepsy (CWE) and maternal sleep quality and depression severity.
A Cross-sectional study was conducted in pediatric sleep disturbances using questionnaires on mother-reported sleep of CWE [Children's Sleep Habits Questionnaire (CSHQ)], maternal sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and maternal depression status [Self-Rating Depression Scale (SDS)]. 114 dyads consisting of CWE and their mothers were included in this study.
Over three-quarters (78.9 %) of mothers reported poor sleep quality (total PSQI score ≥ 5), and nearly a third (29.8 %) met clinical criteria for moderate or severe depression levels. The mothers' total PSQI scores were between 5.93 ± 2.44 (range: 2-16 points). The most affected PSQI subcomponents were sleep latency (AUC = 0.826p < 0.001) and daytime dysfunction (AUC = 0.800p < 0.001). The majority of children (88.6 %) were stated by their mothers to have sleep-related problems. The total CSHQ scores of the children were between 49.06 ± 9.20 (range: 33-86 points). The most affected CSHQ subcomponents were detected sleep anxiety (AUC = 0.856, p < 0.001), bedtime resistance (AUC = 0.818, p < 0.001) and daytime sleepiness (AUC = 0.807, p < 0.001). There was a statistically significant positive correlation between maternal sleep quality and depression severity (rho = 0.842; p < 0.001). A statistically significant positive moderate correlation was detected between sleep problems in CWE and maternal sleep quality and depression severity (rho = 0.406; p < 0.001, rho = 0.399; p < 0.001, respectively). As a result of multiple stepwise logistic regression analysis, the presence of seizures during sleep and generalized epileptiform discharges on electroencephalography were associated risk factors with poor maternal sleep quality (OR:6.6, p = 0.014; OR:11.5, p = 0.018, respectively). A borderline insignificant relationship was observed between a less than 50 % decrease in seizure frequency and the poor maternal sleep quality (OR:20.59p = 0.059). Seizures during sleep was associated risk factor with children's sleep disturbances (OR:7.2, p = 0.02).
Sleep problems in CWE may lead to negative consequences such as sleep quality and/or depression in mothers. Interventions planned to correct sleep disturbances in mothers suggest that children's sleep problems should be optimally managed.
本研究旨在评估儿童癫痫患者（CWE）的睡眠障碍与母亲睡眠质量和抑郁严重程度之间的关系。
采用母亲报告的 CWE 睡眠问卷（儿童睡眠习惯问卷（CSHQ））、母亲睡眠质量（匹兹堡睡眠质量指数（PSQI））和母亲抑郁状况（自评抑郁量表（SDS））对儿科睡眠障碍进行横断面研究。本研究纳入了 114 对 CWE 及其母亲的母子对。
超过四分之三（78.9%）的母亲报告睡眠质量差（PSQI 总分≥5），近三分之一（29.8%）符合中度或重度抑郁水平的临床标准。母亲的 PSQI 总分为 5.93±2.44（范围：2-16 分）。受影响最严重的 PSQI 亚组分是睡眠潜伏期（AUC=0.826p<0.001）和日间功能障碍（AUC=0.800p<0.001）。大多数孩子（88.6%）被母亲报告存在睡眠相关问题。儿童的 CSHQ 总分为 49.06±9.20（范围：33-86 分）。受影响最严重的 CSHQ 亚组分是睡眠焦虑（AUC=0.856，p<0.001）、抗拒上床（AUC=0.818，p<0.001）和日间嗜睡（AUC=0.807，p<0.001）。母亲的睡眠质量与抑郁严重程度呈显著正相关（rho=0.842；p<0.001）。CWE 的睡眠问题与母亲的睡眠质量和抑郁严重程度之间存在显著正相关（rho=0.406；p<0.001，rho=0.399；p<0.001）。多元逐步逻辑回归分析结果表明，睡眠期间发作和脑电图上出现全面性癫痫样放电是母亲睡眠质量差的危险因素（OR：6.6，p=0.014；OR：11.5，p=0.018）。癫痫发作频率降低不到 50%与母亲睡眠质量差之间存在边界显著关系（OR：20.59，p=0.059）。睡眠期间发作与儿童睡眠障碍有关（OR：7.2，p=0.02）。
CWE 的睡眠问题可能导致母亲睡眠质量和/或抑郁等负面后果。计划纠正母亲睡眠障碍的干预措施表明，应优化管理儿童的睡眠问题。
