ORIGINAL ARTICLE
Chronotype and sleep disorders in children with epilepsy
Ayse Aysima Ozcelik,
Mehmet Karadag,
Ayse Aysima Ozcelik
Pediatric Neurology Department, Gaziantep University, Gaziantep, Turkey
Search for more papers by this authorCorresponding Author
Mehmet Karadag
Child and Adolescent Psychiatry Department, Gaziantep University, Gaziantep, Turkey
Correspondence
Mehmet Karadag, Child and Adolescent Psychiatry Department, Gaziantep University, Gaziantep 27100, Turkey.
Email: [email protected]
Search for more papers by this authorAyse Aysima Ozcelik,
Mehmet Karadag,
Ayse Aysima Ozcelik
Pediatric Neurology Department, Gaziantep University, Gaziantep, Turkey
Search for more papers by this authorCorresponding Author
Mehmet Karadag
Child and Adolescent Psychiatry Department, Gaziantep University, Gaziantep, Turkey
Correspondence
Mehmet Karadag, Child and Adolescent Psychiatry Department, Gaziantep University, Gaziantep 27100, Turkey.
Email: [email protected]
Search for more papers by this authorFirst published: 20 March 2023
Abstract
Objective
The circadian rhythm can affect the frequency and resistance of epileptic seizures. In this cross-sectional study, we examined the impact of chronobiology and sleep disturbances on children with epilepsy.
Methods
One hundred and twenty-five children and adolescents (55 patients and 70 controls) were included in the study. All participants were asked to complete the Revised Child Anxiety and Depression Scale—Child Version (RCADS-CV), Sleep Disturbances Scale for Children (SDSC), Childhood Chronotype Questionnaire (CCQ).
Results
According to the CCQ results, controls had longer sleep duration (median 595 vs. 570), lower morningness–eveningness scores (median: 28 vs. 30), and higher rates of the morningness (12.9% vs. 1.8%) and intermediate (74.3% vs. 60%) chronotypes. The children and adolescents with epilepsy scored significantly higher in the Sleep breathing disorders (p = .001), Disorders of arousal nightmares (p = .044), Sleep–wake transition disorders (p = .037), Disorders of excessive somnolence (p = .001), and total SDCS (p = .046) scores. According to the RCADS-CV results, the children with epilepsy scored significantly higher in all subscales in comparison to controls (p < .05).
Significance
Children and adolescents with epilepsy had shorter sleep duration were more likely to be evening-oriented and had more significant sleep disturbance symptoms compared to controls.
CONFLICT OF INTEREST STATEMENT
The authors declare that there is no conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| epd220034-sup-0001-Educational_Slides.pptxPowerPoint 2007 presentation , 40.6 KB |
Data S1 |
| epd220034-sup-0002-Test_Yourself_Answers.docxWord 2007 document , 14 KB |
Appendix S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- 1Dinner DS, Lüders HO. Relationship of epilepsy and sleep: overview. Epilepsy and Sleep. 2001; 1: 1–18.
- 2Hofstra WA, Gordijn MCM, JCvH-vd P, Jvd P, De Weerd AW. Chronotypes and subjective sleep parameters in epilepsy patients: a large questionnaire study. Chronobiol Int. 2010; 27: 1271–86.
- 3Brandt C, Mula M. Anxiety disorders in people with epilepsy. Epilepsy Behav. 2016; 59: 87–91.
- 4Terzano MG, Monge-Straws MF, Mikol F, Spaggiari MC, Parrino L. Cyclic alternating pattern as a provocative factor in nocturnal paroxysmal dystonia. Epilepsia. 1997; 38: 1015–25.
- 5Okun ML, Mancuso RA, Hobel CJ, Schetter CD, Coussons-Read M. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. J Behav Med. 2018; 41: 703–10.
- 6Ekizoglu E, Baykan B, Bebek N, Gurses C, Gokyigit A. Sleep characteristics of patients with epilepsy with pure sleep-related seizures. Epilepsy Behav. 2011; 21: 71–5.
- 7Grayson LP, DeWolfe JL. Sleep disorders in epilepsy: current trends and future perspectives. Curr Sleep Med Rep. 2018; 4: 125–33.
10.1007/s40675-018-0110-y Google Scholar
- 8Rodriguez AJ. Pediatric sleep and epilepsy. Curr Neurol Neurosci Rep. 2007; 7: 342–7.
- 9Mindell JA, Sadeh A, Wiegand B, How TH, Goh DYT. Cross-cultural differences in infant and toddler sleep. Sleep Med. 2010; 11: 274–80.
- 10Beattie JF, Koch SA, Bolden LB, Thompson MD. Neuropsychological consequences of sleep disturbance in children with epilepsy. Epilepsy Behav. 2016; 57: 118–23.
- 11Khan S, Nobili L, Khatami R, Loddenkemper T, Cajochen C, Dijk D-J, et al. Circadian rhythm and epilepsy. Lancet Neurol. 2018; 17: 1098–108.
- 12Aaberg KM, Gunnes N, Bakken IJ, Søraas CL, Berntsen A, Magnus P, et al. Incidence and prevalence of childhood epilepsy: a nationwide cohort study. Pediatrics. 2017; 139:e20163908.
- 13Loddenkemper T, Lockley SW, Kaleyias J, Kothare SV. Chronobiology of epilepsy: diagnostic and therapeutic implications of chrono-epileptology. J Clin Neurophysiol. 2011; 28: 146–53.
- 14Manni R, De Icco R, Cremascoli R, Ferrera G, Furia F, Zambrelli E, et al. Circadian phase typing in idiopathic generalized epilepsy: dim light melatonin onset and patterns of melatonin secretion—Semicurve findings in adult patients. Epilepsy Behav. 2016; 61: 132–7.
- 15Nayak CS, Mariyappa N, Majumdar KK, Ravi GS, Prasad PD, Nagappa M, et al. NREM sleep and antiepileptic medications modulate epileptiform activity by altering cortical synchrony. Clin EEG Neurosci. 2018; 49: 417–24.
- 16Busek P, Buskova J, Nevsimalova S. Interictal epileptiform discharges and phasic phenomena of REM sleep. Epileptic Disord. 2010; 12: 217–21.
- 17Frauscher B, von Ellenrieder N, Dubeau F, Gotman J. EEG desynchronization during phasic REM sleep suppresses interictal epileptic activity in humans. Epilepsia. 2016; 57: 879–88.
- 18Quigg M, Clayburn H, Straume M, Menaker M, Bertram Iii EH. Effects of circadian regulation and rest—activity state on spontaneous seizures in a rat model of limbic epilepsy. Epilepsia. 2000; 41: 502–9.
- 19Minecan D, Natarajan A, Marzec M, Malow B. Relationship of epileptic seizures to sleep stage and sleep depth. Sleep. 2002; 25: 56–61.
- 20Pavlova MK, Shea SA, Scheer FAJL, Bromfield EB. Is there a circadian variation of epileptiform abnormalities in idiopathic generalized epilepsy? Epilepsy Behav. 2009; 16: 461–7.
- 21Quintilham MCT, Adamowicz T, Pereira EF, Pedrazzoli M, Louzada FM. Does the transition into daylight saving time really cause partial sleep deprivation? Ann Hum Biol. 2014; 41(6): 554–60.
- 22Robinson E, DiIorio C, DePadilla L, McCarty F, Yeager K, Henry T, et al. Psychosocial predictors of lifestyle management in adults with epilepsy. Epilepsy Behav. 2008; 13: 523–8.
- 23Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde BW, et al. Revised terminology and concepts for organization of seizures and epilepsies. Report of the ILAE commission on classification and terminology, 2005–2009. New Jersey: Wiley Online Library; 2010.
- 24Mindell JA, Sadeh A, Kwon R, Goh DYT. Cross-cultural differences in the sleep of preschool children. Sleep Med. 2013; 14: 1283–9.
- 25Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE. Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther. 2000; 38: 835–55.
- 26Gormez V, Kılınçaslan A, Orengul AC, Ebesutani C, Kaya I, Ceri V, et al. Psychometric properties of the Turkish version of the revised child anxiety and depression scale–child version in a clinical sample. Psychiatry Clin Psychopharmacol. 2017; 27: 84–92.
- 27Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The sleep disturbance scale for children (SDSC) construct ion and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996; 5: 251–61.
- 28Akçay D, Akçay BD, HekİM BÖ. Çocuklarda Uyku Bozukluğu Ölçeğinin Türkçe güvenilirliği ve geçerliliği. Anatol J Psychiatry/Anadolu Psikiyatri Derg. 2020; 21: 21.
- 29Bilmenoğlu SA. Validity and reliability of TURKISH version of the sleep disturbances scale for children. Edirne: Trakya University; 2019.
- 30Carskadon MA, Vieira C, Acebo C. Association between puberty and delayed phase preference. Sleep. 1993; 16: 258–62.
- 31Zavada A, Gordijn MCM, Beersma DGM, Daan S, Roenneberg T. Comparison of the Munich chronotype questionnaire with the Horne-Östberg's morningness-eveningness score. Chronobiol Int. 2005; 22: 267–78.
- 32Dursun OB, Ogutlu H, Esin IS. Turkish validation and adaptation of children's chronotype questionnaire (CCTQ). The Eurasian Journal of Medicine. 2015; 47: 56–61.
- 33Winsor AA, Richards C, Bissell S, Seri S, Liew A, Bagshaw AP. Sleep disruption in children and adolescents with epilepsy: a systematic review and meta-analysis. Sleep Med Rev. 2021; 57:101416.
- 34Jafar NK, Tham EK, Eng DZ, Goh DY, Teoh OH, Lee YS, et al. The association between chronotype and sleep problems in preschool children. Sleep Med. 2017; 30: 240–4.
- 35Biggs SN, Lushington K, Martin AJ, van den Heuvel C, Kennedy JD. Gender, socioeconomic, and ethnic differences in sleep patterns in school-aged children. Sleep Med. 2013; 14(12): 1304–9.
- 36Reilly C, Agnew R, Neville BG. Depression and anxiety in childhood epilepsy: a review. Seizure. 2011; 20: 589–97.
- 37Kendis H, Baron K, Schuele SU, Patel B, Attarian H. Chronotypes in patients with epilepsy: does the type of epilepsy make a difference? Behav Neurol. 2015; 2015: 1–4.
- 38Pung T, Schmitz B. Circadian rhythm and personality profile in juvenile myoclonic epilepsy. Epilepsia. 2006; 47: 111–4.
- 39Janz D, Christian W. Impulsiv-Petit mal. Deutsche Zeitschrift für. Nervenheilkunde. 1957; 176: 346–86.
- 40Manni R, Cremascoli R, De Icco R, Terzaghi M. Chronotype in patients with epilepsy: a controlled study in 60 subjects with late-onset focal epilepsy. Epilepsy Behav. 2015; 50: 1–6.
- 41Hofstra WA, Van der Palen J, de Weerd AW. Morningness and eveningness: when do patients take their antiepileptic drugs? Epilepsy Behav. 2012; 23: 320–3.
- 42Kwong KL, Lam D, Tsui S, Ngan M, Tsang B, Lai TS, et al. Anxiety and depression in adolescents with epilepsy. J Child Neurol. 2016; 31: 203–10.
- 43Malow BA. Sleep Deprivation and Epilepsy. Epilepsy Curr. 2004; 4: 193–5.
- 44Janz D. The grand Mai épilepsies and the sleeping-waking cycle. Epilepsia. 1962; 3: 69–109.
- 45Friis ML, Lund M. Stress convulsions. Arch Neurol. 1974; 31: 155–9.
- 46Rajna P, Veres J. Correlations between night sleep duration and seizure frequency in temporal lobe epilepsy. Epilepsia. 1993; 34: 574–9.
- 47Macêdo PJOM, de Oliveira PS, Foldvary-Schaefer N, da Mota GM. Insomnia in people with epilepsy: a review of insomnia prevalence, risk factors and associations with epilepsy-related factors. Epilepsy Res. 2017; 135: 158–67.
- 48Lang JD, Grell L, Hagge M, Onugoren MD, Gollwitzer S, Graf W, et al. Long-term outcome after epilepsy surgery in older adults. Seizure. 2018; 57: 56–62.
- 49Yazdi Z, Sadeghniiat-Haghighi K, Naimian S, Zohal MA, Ghaniri M. Prevalence of sleep disorders and their effects on sleep quality in epileptic patients. Basic Clin Neurosci. 2013; 4: 36–41.
- 50Dunn DW, Besag F, Caplan R, Aldenkamp A, Gobbi G, Sillanpää M. Psychiatric and behavioural disorders in children with epilepsy (ILAE task force report): anxiety, depression and childhood epilepsy. Epileptic Disord. 2016; 18: S24–30.
- 51Takeshima M, Ohta H, Hosoya T, Okada M, Iida Y, Moriwaki A, et al. Association between sleep habits/disorders and emotional/behavioral problems among Japanese children. Sci Rep. 2021; 11: 1–8.
- 52Gregory AM, Caspi A, Eley TC, Moffitt TE, O'Connor TG, Poulton R. Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood. J Abnorm Child Psychol. 2005; 33: 157–63.
- 53Ong SH, Wickramaratne P, Tang M, Weissman MM. Early childhood sleep and eating problems as predictors of adolescent and adult mood and anxiety disorders. J Affect Disord. 2006; 96: 1–8.
- 54Schuster M, Oberlinner C, Claus M. Shift-specific associations between age, chronotype and sleep duration. Chronobiol Int. 2019; 36(6): 784–95.
- 55Fischer D, Lombardi DA, Marucci-Wellman H, Roenneberg T. Chronotypes in the US–influence of age and sex. PloS One. 2017; 12(6):e0178782.
- 56Park YM, Seo YJ, Matsumoto K, Shinkoda H, Park KP. Sleep in relation to age, sex, and chronotype in Japanese workers. Percept Mot Skills. 1998; 87(1): 199–215.
- 57Carciofo R, Du F, Song N, Qi Y, Zhang K. Age-related chronotype differences in Chinese, and reliability assessment of a reduced version of the Chinese Morningness Eveningness questionnaire. Sleep Biol Rhythms. 2012; 10(4): 310–8.
- 58Jankowski KS. Composite scale of Morningness: psychometric properties, validity with Munich ChronoType questionnaire and age/sex differences in Poland. Eur Psychiatry. 2015; 30(1): 166–71.
