title: Sleep alterations in children with refractory epileptic encephalopathies: a polysomnographic study.
abstract: Data on the relationship between sleep disturbances and refractory epileptic encephalopathies (EEs) are scarce. Our aim was to assess, by means of nocturnal polysomnography, if children with EEs present with objective alterations in sleep organization. Twenty-three children with EEs (12 males; mean age: 8.7±1.4years) and 40 healthy controls (22 males; mean age: 8.8±1.1years) underwent an overnight full polysomnography (PSG). Relative to controls, children with EEs showed a significant reduction in all PSG parameters related to sleep duration time in bed (TIB-min p<0.001), total sleep time (TST-min p<0.001), and sleep percentage (SPT-min p<0.001), as well as significantly higher REM latency (FRL-min p<0.001), rate in stage shifting (p=0.005), and number of awakenings/hour (p=0.002). Relative to controls, children with EEs also showed significant differences in respiratory parameters (AHI/h p<0.001, ODI/h p<0.001, SpO2% p<0.001, SpO2 nadir% p<0.001) and a higher rate of periodic limb movements (PLMs% p<0.001). Our findings suggest that sleep evaluation could be considered mandatory in children with refractory epileptic encephalopathy in order to improve the clinical management and the therapeutic strategies.
authors.affiliation: Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy. Electronic address: marco.carotenuto@unina2.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Carotenuto
authors.affiliation: Child Neurology, Pediatric Headache & Sleep Disorders Centre, Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza University", Via Di Grottarossa 1035-1039, 00189 Rome, Italy. Electronic address: pasquale.parisi@uniroma1.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
authors.affiliation: Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy. Electronic address: maria.esposito2@unina2.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Esposito
authors.affiliation: Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK. Electronic address: samuele.cortese@gmail.com.
authors.forename: Samuele
authors.initials: S
authors.lastname: Cortese
authors.affiliation: Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via Conte Ruggiero 73, 94018 Troina (EN), Italy. Electronic address: melia@oasi.en.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Elia
mesh_terms: D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology*
keywords: Epileptic encephalopathy; Pediatric polysomnography; Periodic limb movements; Sleep obstructive apnea syndrome; Sleep-related breathing disorders