title: Cerebral modulation of circadian sleep-wake rhythms.
abstract: The objective of this prospective observational study was to assess the association between dysrhythmia of EEG background (disturbance of cerebral connectivity) and sleep difficulties. Sixty children, aged 4 to 12 years, participated. Hospital records were reviewed, and sleep histories were obtained by interviewing the parents. EEGs of 39 subjects were normal, showed epileptiform activity, and/or mild to moderate background dysrhythmia. Severe unilateral dysrhythmia was noted in 6 and bilaterally in 15 EEGs, with all 15 children having profound neurodevelopmental disabilities and 14 of these 15 having long-standing severe chaotic sleep/wake patterns. Thus, there was a highly significant association between EEG evidence of severe bilateral dysrhythmia and chronic sleep/wake dysregulation. Unilateral dysrhythmia was not associated with sleep difficulties. This study delineates a specific sleep disorder in a group of children with marked neurodevelopmental disabilities and offers insight into how disturbed cerebral connectivity impacts the thalamocortical dynamics relating to neurodevelopmental disabilities, sleep, and melatonin production.
authors.affiliation: Diagnostic Neurophysiology, British Columbia Children's Hospital, 4500 Oak Street, Vancouver, BC, Canada. jjan@cw.bc.ca
authors.forename: James E
authors.initials: JE
authors.lastname: Jan
authors.forename: Urs
authors.initials: U
authors.lastname: Ribary
authors.forename: Peter K H
authors.initials: PK
authors.lastname: Wong
authors.forename: Russel J
authors.initials: RJ
authors.lastname: Reiter
authors.forename: Martin C O
authors.initials: MC
authors.lastname: Bax
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wasdell
mesh_terms: D001921:Brain / Q000503:physiopathology*; D058256:Brain Waves; D001955:British Columbia; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D002940:Circadian Rhythm; D002658:Developmental Disabilities / Q000503:physiopathology* / Q000523:psychology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D009434:Neural Pathways / Q000503:physiopathology; D011446:Prospective Studies; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D014851:Wakefulness