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Children with epilepsy and their parents reported suffering from sleep problems, researchers found.

In a survey-based study, households with epileptic children reported significantly more sleep disturbances compared with households that served as controls (P<0.001), wrote Elizabeth Thiele, MD, of Massachusetts General Hospital (MGH) in Boston, and colleagues in Epilepsia. Additionally, their parents reported more sleep dysfunction and fatigue (P=0.005 and P<0.001, respectively).

"Pediatric epilepsy can deeply affect the sleep patterns and behaviors of both the affected child and the parents," the authors wrote.

Research has shown that having the condition impacts kids' sleep, but few studies have characterized the association between epilepsy and parental sleep quality and household sleeping arrangements. That's important because parents may be sleeping poorly, because of the child's disrupted sleep and because of the fear and anxiety that the child will have a seizure at night, the researchers said.

Thiele and colleagues sent surveys to parents of children, ages 2 to 10, who were seen at an outpatient general pediatric care practice at MGH between January 2010 and January 2011.

Some of the children had epilepsy, while others served as controls. The survey included questions about seizure history, child and parent sleep, and household sleeping arrangements.

The researchers also assessed children's sleep disturbances, the parents' sleep and fatigue, and epilepsy severity.

The study response rate was 18.7%, and included 105 households with a child with epilepsy and 79 controls.

Thiele and colleagues found that children with epilepsy had greater sleep disturbances overall (P<0.001), including higher rates of parasomnias, night wakings, sleep duration, daytime sleepiness (P<0.001 for all), as well as sleep onset delay (P=0.009) and bedtime resistance (P=0.023).

Their parents also had significantly increased sleep dysfunction and were more fatigued than control parents, they reported (P=0.005 and P<0.001, respectively).

Epilepsy severity was positively linked with several parameters, including the degree of the child's sleep dysfunction (P=0.049), the parents' sleep dysfunction (P=0.005), and parental fatigue (P=0.001).

They also found that children with epilepsy were more likely to share either a room or a bed with their parents compared with controls (P<0.001 and P=0.005, respectively), and both types of co-sharing were associated with child sleep problems.

Overall, nocturnal seizures were associated with parental sleep problems, whereas room sharing and co-sleeping behavior were associated with child sleep problems.

Within the epilepsy cohort, 69% of parents felt concerned about night seizures, and 44% reported rarely or never feeling rested.

Although only a limited number of epilepsy covariates appeared to be potential predictors of sleep problems in kids, antiepileptic drug polytherapy was significantly predictive of greater childhood sleep disturbances, the researchers said.

They warned, however, that it's hard to know whether the drugs directly affected sleep or if polytherapy solely acts as a surrogate for disease severity.

They concluded that clinicians treating epileptic pediatric patients should pay attention to sleep issues in the entire household. The data also "provide evidence of a profound clinical need for improved epilepsy therapeutics and the development of nocturnal seizure monitoring technologies," they wrote.

The study was limited by its relatively low response rate and a statistically significant age difference between the two cohorts.

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