J Pediatr. 2024 Nov 16:114412. doi: 10.1016/j.jpeds.2024.114412. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate whether abnormal sleep is associated with adverse outcomes for children who survived acute provoked neonatal seizures, and their parents’ well-being.
STUDY DESIGN: This 9-center study prospectively followed newborns with acute provoked seizures. When children reached age 5 years, parents completed the Children’s Sleep Habits Questionnaire (CSHQ), the Pediatric Sleep Questionnaire-Sleep Related Breathing Disorders (PSQ-SRBD) subscale, Vineland Adaptive Behavior Scales-3, and the Hospital Anxiety Depression Scale (HADS). Children were also assessed with the Wechsler Preschool and Primary Scale of Intelligence-IV (WPPSI-IV). Spearman correlations and multivariable analyses were used to evaluate risk factors for sleep problems.
RESULTS: The mean CSHQ score was 45±7; 77/118 (65%) scored abnormally above the healthy sleep threshold of 41. On the PSQ-SRBD, 32/119 (27%) screened positive for sleep-disordered breathing (SDB). SDB symptoms were more common among children with cerebral palsy (42% with vs. 22% without, p=0.03) and epilepsy (54% with vs. 24% without, p=0.02). Children with lower scores on the Vineland-3 (rho=-0.25, p=0.01) and WPPSI-IV (rho=-0.31, p=0.004) at age 5 years were more likely to have symptoms of SDB. Worse CSHQ and PSQ-SRBD scores were associated with higher parental anxiety (rho=0.28, p=0.002, and rho=0.34, p=0.0002, respectively) and depression scores on the HADS (rho=0.16, p=0.08, and rho=0.17, p=0.07, respectively).
CONCLUSIONS: Two-thirds of early school-aged survivors of acute provoked neonatal seizures had parent-reported sleep abnormalities and one quarter screened positive for SDB. Early screening and effective treatment for sleep disorders could be an innovative, practice-changing approach to improve outcomes after neonatal seizures.
PMID:39557387 | DOI:10.1016/j.jpeds.2024.114412
