A case-control study to investigate the prevalence of obstructive sleep apnea and the utility of the PSQ-SRBD questionnaire in children and young people with epilepsy

Don Urquhart, Ailsa McLellan, Laura Hill, Emma Carruthers, Elizabeth A Hill, Richard Chin, Jay Shetty

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Study Objectives
Epilepsy and obstructive sleep apnea syndrome (OSAS) are each relatively common in children. OSAS may affect cognition, such that recognition of OSAS is important for children and young people with epilepsy (CYPWE). Published pilot data reported 55% CYPWE had symptoms suggestive of OSAS, compared with 7% typically-developing controls. The primary aim of this study was to ascertain OSAS prevalence by polysomnography (PSG) in CYPWE, with secondary aims being to evaluate the utility of sleep questionnaires in CYPWE.

Methods
Children and young people with epilepsy and age- and sex-matched typically-developing controls were studied. A single night of level I attended PSG was undertaken, along with questionnaires [Pediatric Sleep Questionnaire (PSQ-SRBD), Pittsburgh Sleep Quality Index (PSQI) and the childhood and adolescent Epworth Sleepiness Scale (ESS-CHAD)]. OSAS was defined as obstructive apnea/hypopnea index (oAHI) of >1/hr.

Results
Polysomnography was performed in 72 children including 48 CYPWE (60% male) and 24 controls (54% male). Mean age (11 years) was similar for CYPWE and controls, p= 0.42; with slightly higher BMI z scores (0.7 v 0.1, p=0.03) noted in CYPWE. Mean oAHI was 0.61 in CYPWE versus 0.42 (controls), p=0.62. Despite higher PSQ-SRBD scores in CYPWE (0.38 v 0.12, p<0.001), no difference in OSAS prevalence (10% vs. 4%, p=0.78) was found. Children and young people with epilepsy had higher ESS-CHAD (6 vs. 3.5, p=0.01) and PSQI (5 vs. 3.3, p=0.02) scores indicating greater levels of daytime sleepiness and poorer sleep quality.

Conclusions
The study found no evidence for increased OSAS prevalence in CYPWE, whilst the utility of the PSQ-SRBD in predicting OSAS appears limited for CYPWE. Children and young people with epilepsy are, however demonstrably sleepier with poorer sleep quality. The cause for these findings remains unclear.
Original languageEnglish
JournalJournal of clinical sleep medicine
DOIs
Publication statusPublished - 6 Feb 2024

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