Rapid eye movement sleep reduction in pediatric epilepsy: A propensity score-matched study.
Rapid eye movement sleep is reduced in children with epilepsy versus matched nonepilepsy comparators
Rapid eye movement sleep reduction in pediatric epilepsy: A propensity score-matched study.
This study was undertaken to characterize sleep architecture assessed by polysomnography (polysomnography) in children with epilepsy versus matched nonepilepsy clinical comparators and disentangle disease from antiseizure medication (antiseizure medication) effects.
In this cross-sectional analysis of the Nationwide Children's Hospital Sleep DataBank (3647 polysomnography studies from 3392 patients aged ≤18 years), a clinical cohort referred for polysomnography, we compared 560 polysomnography studies in children with epilepsy to 3087 studies in nonepilepsy clinical comparators.
The effect followed a developmental gradient: strongest at age < 6 years (g = -.38, p < .001), intermediate at 6-12 years (g = -.31, p = .002), and not detected at >12 years (g = -.07, p = .953).
Excluding benzodiazepine users attenuated the signal (g = -.24), whereas excluding melatonin users preserved it (g = -.29).
SIGNIFICANCE: In the largest pediatric epilepsy polysomnography study to date, epilepsy is associated with an rapid eye movement-predominant sleep disruption concentrated in children younger than 6 years and amplified by ASMs, although the independent contribution of epilepsy itself remains uncertain.
These cross-sectional findings identify early childhood as a period of heightened vulnerability that warrants prospective study.