Sleep Disorders In Children Research Articles

Prevalence of sleep disorders in children with chronic kidney disease: a meta-analysis.

The reported prevalence of sleep disorders in children with chronic kidney disease (CKD) varies greatly. A quantitative meta-analysis to estimate the prevalence of sleep disorders among pediatric CKD patients may provide further information. The objective of this study is to estimate the prevalence of sleep disorders in children with CKD. The study protocol was registered on PROSPERO (registration number CRD42021268378). Two authors independently searched the PubMed, MEDLINE, EMBASE, and Cochrane review databases up to June 2021. Eligible studies include data of prevalence of sleep disorders in children with CKD. The prevalence of restless legs syndrome, sleep-disordered breathing, pediatric obstructive sleep apnea (i.e., apnea-hypopnea index > 1 event/h in polysomnography), excessive daytime sleepiness, and insomnia/insufficient sleep was estimated using a random-effects model. Subgroup analyses were conducted to compare the prevalence of sleep disorders between children on dialysis and not on dialysis. This meta-analysis included 12 studies with 595 children (mean age: 12.9years; gender ratio: 55.6% boys; mean sample size: 49.6 patients). The prevalence of restless legs syndrome in children with CKD was 21% (95% confidence interval [CI], 14-30%). The prevalence of sleep-disordered breathing, pediatric obstructive sleep apnea, excessive daytime sleepiness, and insomnia/insufficient sleep was 22% (95% CI, 12-36%), 34% (95% CI, 19-53%), 27% (95% CI, 17-41%), and 14% (95% CI, 7-27%), respectively. Subgroup analysis revealed the pooled prevalence of excessive daytime sleepiness was significantly higher in children on dialysis than in children not on dialysis (43.3% vs. 11.2%; P = 0.018). Children on dialysis also had a high prevalence of other sleeping disorders, although the differences did not reach statistical significance. Children with CKD exhibited a 3.9-fold (95% CI, 1.37 to 10.93) increased risk of restless legs syndrome and a 9.6-fold (95% CI, 3.57 to 25.76) increased risk of excessive daytime sleepiness compared with controls. The selected papers are of small sample size, lack of a control group, and exhibit substantial heterogeneity. Sleep disorders are common in children with CKD. Our results indicate that while the prevalence rates of various sleep disorders were higher in children on dialysis than in children not on dialysis, the prevalence of excessive daytime sleepiness was statistically significant in children on dialysis. A higher resolution version of the Graphical abstract is available as Supplementary information.

Pharmacologic Approaches to Insomnia and Other Sleep Disorders in Children

Pharmacologic Approaches to Insomnia and Other Sleep Disorders in Children

Effect of virtual reality-based exercise intervention on sleep quality in children with acute lymphoblastic leukemia and healthy siblings: A randomized controlled trial.

Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality-based exercise (VRBE) approaches on sleep in patients with acute lymphoblastic leukemia (ALL) off treatment. The participants (ALL and healthy siblings) were evaluated for sleep quality with polysomnography and "Children's Sleep Habit Questionnaire" before and after 12 weeks. The study randomized into two groups: an exercise group who received VRBE in two days in a week, 45 min of each session for 12 weeks and an control group who were managed with supportive measures. The VRBE comprised of aerobic exercise in four different games by Nintendo Wii Fit Plus®. This randomized controlled trial was carried out on 38 participants. Before intervention, ALL patients (n = 24) and healthy siblings (n = 14) had similar sleep quality in terms of polysomnography and Children's Sleep Habit Questionnaire findings. After intervention, total time asleep (p = 0.023), respiratory disturbance index of hypopnea (p = 0.005), apnea/hypopnea index (p = 0.008), and number of apnea (p = 0.028) statistically significant improved. Patients with ALL off treatment had similar values of sleep quality with healthy siblings. Novel types of exercises like VRBE have positive effects on sleep disorders in children with ALL and also healthy siblings. Future studies are needed comparing the different types of interventions.

Children with neurodevelopmental disorders: how do they sleep?

In this review we summarized the available evidence on sleep disorders in children with neurodevelopmental disorders (NDDs) in particular: intellectual disability (including some genetic conditions such as Prader-Willi Syndrome, Smith-Magenis Syndrome), Autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), Developmental Coordination Disorder, language disorders, and specific learning disorders. Children with NDDs frequently suffer from sleep disturbances, with a higher prevalence than that of the general pediatric population. These problems tend to be chronic and may cause additional cognitive and behavioral difficulties, often affecting the whole family's well-being. Sleep behaviors are also related to other important developmental skills, such as attention and listening. Investigating sleep disorders in children with NDDs is therefore crucial in clinical practice. For a systematic approach in clinical practice, we propose the use of a short and easy to remember sleep screening tool.

Inflammatory Biomarkers for Children with Sleep Disorders: A Review

AbstractIntroduction Obstructive sleep apnea (OSA) syndrome is a highly prevalent problem in children. Unfortunately sleep disorders in children remain largely unreported and underdiagnosed due to various reasons. Overnight in-laboratory polysomnography (PSG) is the gold standard diagnostic method for OSA; however, it has several drawbacks. Hence there is a need for simple alternative diagnostic methods, such as biomarkers. Children with OSA seem to have an inflammatory aspect to its pathophysiology; thus the rationale for evaluating inflammatory biomarkers.Objective This narrative review aimed to evaluate the existing knowledge regarding inflammatory biomarkers for children with sleep disorders.Materials and Methods An extensive search of all literature linked to the topic was performed in PubMed, Medline, EBSCOhost, Cochrane library database CENTRAL, and Google Scholar search engine. Keywords used in the search included combinations of the following: inflammation, sleep disorders, children, and biomarkers. Studies in the list of references of relevant literature were also included. A total of 155 articles published in the period from 1997 to 2021 were initially included in this review. Selected articles comprised original research, meta-analysis, and systematic reviews.Results Studies have mainly centered their investigations on serum inflammatory biomarkers, namely interleukin-6, tumor necrosis factor-α, and C-reactive protein. Very few studies investigated salivary inflammatory biomarkers in children.Conclusion Evidence suggests that children with sleep disorders have elevated levels of salivary as well as serum inflammatory biomarkers in comparison to normal healthy children. Also increased levels of these biomarkers correlate with disease severity. However, more studies are needed to determine the sensitivity and specificity of salivary inflammatory biomarkers for children with sleep disorders.

The Role of Vitamin D in Sleep Disorders of Children and Adolescents: A Systematic Review.

This review investigates the association between vitamin D and sleep disorders. Vitamin D is an essential nutrient known to play an important role in the growth and bone health of the human body, but it also appears to play a role in sleep. The goal of our review is to examine the association between vitamin D and sleep disorders in children and adolescents. We summarize the evidence about the role and the mechanism of action of vitamin D in children and adolescents with sleep disorders such as insomnia, obstructive sleep apnea (OSA), restless legs syndrome (RLS), and other sleep disorders. Systematic electronic database searches were conducted using Pubmed and Cochrane Library. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The studies that met the established inclusion criteria were analyzed and compared. Results suggest a strict relationship between vitamin D deficiency in children and sleep disorders. There is evidence that vitamin D is implicated in the different neurochemical mechanisms involved in sleep regulation and mainly in the serotonergic and dopaminergic pathways. This might be responsible for the association of vitamin D deficiency and restless sleep, sleep hyperhidrosis, OSA, and RLS.

Effect of allergic rhinitis on sleep in children and the risk factors of an indoor environment.

Allergic rhinitis (AR) is an independent risk factor for sleep disorders in children, including abnormal sleep behaviors. We investigated the occurrence of abnormal sleep behaviors in children with AR to determine indoor environmental risk factors affecting sleep. This case-control study collected the sleep status and characteristics of the indoor environment of children aged 3-14 yearswith and without AR using a questionnaire. The differences between the two groups were compared using the Mann-Whitney U test, chi-square test, and Fisher's exact test. The indoor environmental factors affecting sleep behavior were analyzed using logistic regression analysis. Children with AR(n=427) had a higher probability of snoring (8.7 % vs. 2.9 %; P < 0.001), mouth breathing (14.1 % vs. 5.2 %; P < 0.001), restless sleep (6.6 % vs. 4.1 %; P = 0.047), sleep talking (3.3 % vs. 1.1 %; P = 0.003), and hyperhidrosis (16.4 % vs. 8.5 %; P < 0.001) than those without AR (n=1046). Emulsion wall paint (odds ratio (OR) = 2.779; 95 % confidence interval (CI), 1.332-5.796; P = 0.006) and tobacco exposure in early infancy (OR = 2.065; 95 % CI 1.079-3.950; P = 0.029) were associated with hyperhidrosis. Children with AR are more likely to have abnormal sleep behaviors than those without, including snoring, mouth breathing, restless sleep, sleep talking, and hyperhidrosis. Emulsion paint wall and tobacco smoke exposure in early infancy had a twofold higher risk of hyperhidrosis during sleep.

Experience of Teraligen usage in pediatric psychiatry

The data of studies on the use of Teraligen in various fields of clinical medicine - neurology, dermatology, gastroenterology, anesthesiology and psychiatry are presented. According to studies conducted in psychiatry, Teraligen is a drug for the balanced treatment of anxiety-phobic, behavioral and sleep disorders in children, both within neurotic conditions and in the structure of autistic and schizophrenic spectrum disorders. Based on 100 case histories of children aged 3 to 16 years, the experience of using Teraligen as part of mono- and combination therapy at a dosage of 1.25 mg to 50 mg/day in the treatment of autism spectrum disorders (n=31), psychotic disorders (n=18), schizotypal disorders (n=41), behavioral and emotional disorders on residual organic soil (n=10). A good clinical effect of Teraligen has been shown in anxiety-phobic, affective, somatovegetative disorders and sleep disorders in all identified nosologies. Good tolerability of Teraligen, the possibility of its use as part of complex therapy and the almost complete absence of adverse events, indicating the softness and balance of the drug were noted.

Administration in Efficacy of Melatonin Reducing Headaches in Children With Migraines and Sleep Disorders: A Randomized Clinical Trial Study.

Migraine headache after tension headache is the most common primary headache in children, and sleep disorders can aggravate the symptoms. Melatonin has been proposed in some studies for prophylaxis of migraine headaches. This study aimed to evaluate melatonin's effect on migraine symptoms in children with migraine headaches and sleep disorders. In this randomized clinical trial study, all 30 children aged 5 to 15 years with migraine headaches and sleep disorders were referred to the Pediatric Neurology Clinic and enrolled. Patients were randomly divided into two equal groups; the intervention group was treated with melatonin (3 mg daily) and propranolol (1 mg/kg daily), and the control group was treated with propranolol alone (1 mg/kg daily). The severity of the migraine headaches was assessed with PEDMIDAS and a five-point Likert scale. The children's sleep habits questionnaire (CSHQ) assessed children's sleep disorders. The ANOVA and linear regression methods were used to analyze and compare the findings between the groups. Out of 30 children participating in the study, 9 were girls, and 21 were boys. The number of daily headaches one month (P = 0.02) and four months (P = 0.03) after treatment was significantly lower in the melatonin group compared to the control group. Regarding sleep quality, there was no significant difference between the two groups. Melatonin and propranolol could better alleviate migraine headaches than propranolol alone in children.

Sleep and mental health in children and adolescents

Sleep is an essential biological function of our life. The duration and pattern of sleep varies from animals to animals. We human beings sleep nearly 6 to 8 hours during night time. This consolidated night time sleep pattern normally achieved at around 4 years of age and continues thereafter. It is seen that sleep has an important role in overall growth and cognitive development of the child. Any disturbances in quality or duration of sleep in childhood may predispose the child to many physical and mental disorders in later ages. Some of the childhood sleep disorders resolve spontaneously, some resolve with age and some may persist throughout the life as a genetic burden. On the other hand many of the mental disorders of childhood and adolescent affect the sleep pattern of the individual. Substance abuse in adolescents is a challenging situation where unhealthy sleep pattern considered having a great role. This review article is meant to focus how sleep disturbances in childhood can predispose to mental illness and in turn how various mental disorders affect the normal sleep pattern of a child.

Profile of paediatric sleep patients and polysomnography findings: Experience from an exclusive paediatric sleep clinic in India

Objectives: The objectives of the study were to describe the profile of patients attending an exclusive paediatric sleep clinic in India. Materials and Methods: Children aged 1 month–18 years, attending an exclusive paediatric sleep clinic, were assessed using standardized questionnaires. Children underwent sleep coaching, were treated medically, or underwent polysomnography based on the decision of the paediatric pulmonologist. Level 1 polysomnography was conducted by trained personnel. Results: Of 186 children, 36.5% were for infant sleep issues, 24.7% suspected obstructive sleep apnea (OSA), 18.2% neuromuscular diseases with sleep problems, 15.6% genetic disorders with sleep problems, 4.3% parasomnias, and 0.5% abnormal movements during sleep. Of the 85 paediatric polysomnographies conducted, 9.4% were normal studies, 87% had OSA, 1.1% restless leg syndrome, and 2.3% were inadequate studies. Conclusion: Sleep disorders in children are not uncommon and paediatricians need to be aware and identify them early. More number of exclusive paediatric sleep clinics need to be established in India.

Sleep disorders in children and adolescents with tension-type headaches

Introduction. Tension-type headache (TTH) represents a widespread and recurrent disease in adults, children, and adolescents, adversely affecting the quality of life, learning achievements, and social functioning. In recent publications, a high incidence of comorbid disorders in patients with TTH is discussed, in particular sleep disorders. The aim of the study was to assess the nature and prevalence of sleep disorders in children and adolescents with frequent episodic TTH and chronic TTH. Materials and methods. One hundred fifty patients aged from 8 years to 16 years 11 months with TTH were examined. Of them, 91 (49 boys, 42 girls) had frequent episodic TTH, 59 (26 boys, 33 girls) had chronic TTH. There was used Sleep Disturbance Scale for Children including 26 questions for parents. Results. The present study confirms the high incidence of sleep disorders among TTH children and adolescents. TTH was diagnosed in 129 (86.0%) out of 150 patients. The most frequently diagnosed varying degrees of severity (clinically relevant and borderline, when assessing sleep disorders in children) were insomnia (disorders of initiating and maintaining sleep) - in 65.3% of patients (including 60.4% with frequent episodic TTH and 72.9% with chronic TTH), excessive somnolence - in 74.7% (67.1% and 86.4%), sleep breathing disorders - in 26.7% (23.1% and 32.2%), disorders of arousal/nightmares - in 46.0% (42.9% and 50.8%), sleep-wake transition disorders - in 65.3% (67.1% and 62.7%), sleep hyperhidrosis - in 31.3% (26.4% and 39.0%). Thus, all sleep disorders (except for sleep-wake transition disorders) were significantly more common among the patients with chronic TTH. At the same time, in the subgroup of patients with TTH and any sleep disorders, significantly more prominent indicators of the frequency, the intensity of TTH and its negative impact on the daily activity were revealed, compared to patients with TTH lacking sleep disorders. Conclusion. The results of the assessment of children and adolescents with TTH show that when planning preventive therapy for TTH and evaluating its results, not only main clinical characteristics of TTH should be taken into account, but also the manifestations and severity of comorbid disorders, including sleep disorders observed in most patients with TTH. The revealed prevalence of various sleep disorders in the subgroup of patients with chronic TTH confirms that sleep disorders and anxiety disorders refer to significant risk factors for the transition of TTH to a chronic form, and such patients need more active multimodal treatment.

The Interventions for Sleep Disorders in Children with Attention Deficit and Hyperactivity Disorder: A Narrative Review

BACKGROUND: Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children with ADHD have more frequent comorbid sleep disorders than healthy children. The current methods of treating sleep disorders in ADHD children are still focused on pharmacological interventions which in fact only provide little benefit. AIM: This study aims to identify existing studies regarding the types of nonpharmacological and complementary interventions for sleep disorders in children with ADHD using a narrative review approach. METHODS: This was a narrative review. Inclusion criteria included articles in English and Bahasa, full-text articles, primary studies, and children with ADHD aged 18 years with or without comorbidities as the research sample, and the article having been published in the last 10 years. Searches were performed in several databases: PubMed, Springer, Web of Science, and Google Scholar. RESULTS: The result showed that programs for managing sleep disorder in ADHD are behavioral therapy, behavioral parent training (BPT), behavioral sleep intervention, neurofeedback, mind-body therapy, L-theanine supplementation, horse milk supplementation, and play therapy. The programs are found to be effective in improving sleep. CONCLUSION: The program most comprehensive with a high level of ease of implementation was BPT.

Sleep Disorders in Early Childhood and the Development of Mental Health Problems in Adolescents: A Systematic Review of Longitudinal and Prospective Studies.

The association between sleep problems, particularly sleep disorders, and mental health has long been studied and recognized. However, the causal relationship between sleep disorders, particularly during early childhood, on mental health problems in adolescence are yet to be established. From a preventive perspective, it is important to understand the causality of mental health problems in adolescents so that intervention measures can be derived and implemented as early as possible for maximum effectiveness. To provide more precise information on the effect of early childhood sleep disorders on mental health problems during adolescence, a systematic review was conducted on longitudinal and prospective studies reported in the literature. Following the PRISMA guidelines with an extensive search of the literature 26 studies were identified. Seven of these identified studies satisfied all selection criteria with sufficient data on the effect of early childhood sleep disorders and mental health problems in adolescence. Information was extracted and analyzed systematically from each study and tabulated. The overall results obtained from these studies indicate a significant and possible causal relationship between early childhood sleep disorders and the development of mental health problems, such as anxiety, depression, and ADHD in adolescence. These results are discussed with regards to the theoretical and practical implications as well as preventive strategies.

Home (Level 2) polysomnography is feasible in children with suspected sleep disorders

AimTo audit the feasibility and patient experience of home polysomnography (sleep study) for the investigation of a sleep disorder in children. MethodsThe signal quality and outcomes of a Level 2 (home) polysomnography in young people undergoing investigation between September 2020 and January 2021 in a single centre was reviewed. A successful home polysomnogram was defined as a study with ≥6 h of sleep and all channels (EEG, thoraco-abdominal bands, calculated airflow, and pulse oximetry) present for at least 90% of the study time. Feedback from the guardian and young person was collected following the study using a questionnaire. ResultsFifty-five patients, aged 4 months to 18 years, were included. A successful polysomnogram, on the first attempt, was achieved for 48/55 (87%) subjects. There were no differences in success when accounting for neurodevelopmental conditions, OSA severity or age. The majority (76%) of guardians felt that their child slept the same or better than normal and only 12% found having the study conducted at home difficult. Following the study, only 8% would have preferred a hospital sleep study in retrospect. ConclusionsHome polysomnography produced a technically adequate study for the majority of subjects. Most families also found the experience of having a home sleep study to be positive. These data support the use of home sleep studies as an alternative to an in-patient sleep study, in appropriate circumstances, for young people undergoing investigation of a sleep disorder.

Screening Sleep Abnormalities in Children with Prader–Willi Syndrome: Challenges in the Indian Scenario

There is a high prevalence of sleep-related breathing disorders in the form of obstructive and central sleep apnea as well as spontaneous oxygen desaturation in children with Prader–Willi syndrome (PWS). Most cases are asymptomatic and if untreated go on to develop unfavorable neurodevelopmental, cardiovascular, and cerebrovascular outcomes. Hence, sleep study or polysomnography (PSG) is recommended in all children at the time of diagnosis as well as with the development of certain risk factors including symptoms of sleep apnea, before and after initiation of recombinant growth hormone (rGH) therapy. The use of rGH in children with PWS has been shown to improve central sleep apnea but also shown to be associated with worsening of OSA. PSG is ideally performed in a sleep laboratory. Various types of PSG devices are available depending on the biological parameters that are desired to be monitored. Sleep disorders in children are distinct from those seen in adults and have different diagnostic scoring criteria necessitating a trained pediatric sleep specialist to analyze the PSG recording. Through the clinical case vignette of a 14-year-old girl with PWS, severe obesity, and sleep disordered breathing, this review aims to highlight the need, timing, types, analysis, and interpretation of sleep studies in infants and older children with PWS, particularly in relation to rGH therapy. There is a paucity of literature on sleep studies in children with PWS in the local setting. Thus this review also suggests the need for adapting the existing Western guidelines for PSG in Indian children with PWS.

P015 Home (Level 2) sleep studies are feasible in children

Abstract Introduction In-hospital polysomnography (PSG or Level 1 study) is the “gold-standard” for investigating sleep disorders in children. There are long waiting lists for sleep studies in Australian tertiary centres. Level 2 home-PSG has been proposed as an alternate option. However, there are limited data regarding the feasibility in a clinical population. The aim of this study is to assess the feasibility and patient experience of home-PSG in a clinical cohort. Methods The signal quality and outcomes of a home-PSG in young people undergoing sleep investigation in a single centre were reviewed. A successful home-PSG was defined as a study with ≥ 6hrs of sleep and all channels present for ≥90% of sleep time. Feedback from the guardian/young person was collected using a questionnaire. Results Fifty-five patients (4m-18yrs) were included. Successful home-PSG, on the first attempt, was achieved for 48/55 (87%) patients. There were no differences in success when accounting for neurodevelopmental conditions, OSA severity or age. A clinical diagnosis was confidently made in 53 (96%) patients. The majority (76%) rated their sleep as the same or better than normal and only 12% found having the study conducted at home difficult. Following the study, only 8% would have preferred a hospital sleep study. Discussion Home-PSG produced technically adequate recordings for most subjects and families found the experience of having a home sleep study to be positive. These data support, in appropriate circumstances, home-PSG as a viable alternative to an in-patient sleep study.

Brain tumours result in sleep disorders in children and adolescents

Background and objectivesSleep disturbances are frequently reported in children with brain tumours. The objective of our cross-sectional study was to systematically examine sleep in these children. We hypothesised that children with tumours involving the sleep-wake-regulatory areas have an altered sleep-wake-regulation. MethodsSixty-one patients aged 0–18 years and with a diagnosis of a primary brain or cervical medullary tumour were included. They were categorised based upon tumour location into two groups – those affecting the sleep-wake regulatory regions, i.e. brain stem, basal forebrain, hypothalamus, thalamus, and posterior fossa compressing the brain stem and those that did not. Sleep history, questionnaire surveys, polysomnography, and multiple sleep latency test were used, as indicated clinically. Surveys included Pediatric Daytime Sleepiness Scale, Children's Sleep Habits Questionnaire, Strengths and Difficulties Questionnaire, and Pediatric Quality of Life Inventory, Multidimensional Fatigue Scale and Generic Core Scale. ResultsPatients with tumours involving the sleep-wake regulatory areas were sleepier/more fatigued (p = 0.03). Sleep apnoea was observed in 86% of all the patients and comorbid narcolepsy in 8%, without group differences (p ≥ 0.12). Patients with tumours involving the sleep-wake-regulatory areas had more emotional problems (p = 0.04), were more affected by mental health problems (p < 0.001), and had poorer quality of life (p ≤ 0.03). ConclusionsMany children with brain tumours suffer from disturbed sleep, poor mental health, and low quality of life. We recommend that systematic sleep evaluation is included in their routine care along with psychological and social support.

Prevalence of Sleep Disorders in Children with Cerebral Palsy; A Questionnaire-based Observational Study.

Cerebral palsy (CP), the most common developmental disorder, has many comorbidities (epilepsy and behavioral issues). Sleep disturbances are common complaints of parents and are usually neglected in pediatric populations in comparison to other well-documented co-morbidities of CP but may have a significant effect on the quality of life of children and their parents. To study the prevalence and pattern of sleep disorders (SD) in children with CP. Questionnaire-based observational study. Pediatric tertiary care center. The study was done over 6 months. In total, 200 children with CP between the ages of 1 year to 14 years were included in the study by convenience sampling. Co-morbid health problems involving cardiorespiratory system, other illness (e.g. epilepsy and gastroesophageal reflux disease), or children on anticonvulsant medications altering sleep patterns were excluded. The Sleep Disturbance Scale for Children (SDSC) was administered to assess the presence of pathological sleep and type of SD ranging between Disorders of Initiation and Maintenance of Sleep (DIMS), Sleep Breathing disorders (SBD), Disorders of Arousal (DA), Sleep-Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DES), and Sleep Hyperhydrosis (SHY). Sixty-two percentage of children (124) had a pathological total sleep score (score >39). DIMS are the most common, occurring in 78.2% of subjects with a pathological sleep score (score >39). Quadriplegics [n = 96, mean score = 49.86(16.38)] and GMFCS V [n = 19, mean score = 58.00(17.10)] are most severely affected. Children with CP have under-reported SD and DIMS is the most common type of SD. There is a linear correlation between the extent of topographical and motor afflictions and SD.

Sleep disorders in childhood epilepsy

Sleep has a great influence on epileptic seizures and epilepsy significantly affects the quality and restorative functions of sleep. Clinical research has found a fairly high prevalence in children with epilepsy compared to healthy children . The aims of our study: -Study the risk factors for sleep disorders in children with epilepsy -Identify the most frequent sleep disorders.