title: Understanding sleep problems in children with epilepsy: Associations with quality of life, Attention-Deficit Hyperactivity Disorder and maternal emotional symptoms.
abstract: OBJECTIVE
  This study aimed to (1) compare sleep problems between children and adolescents with epilepsy and non-epileptic controls, and (2) examine whether there is an association between sleep problems and quality of life, Attention-Deficit Hyperactivity Disorder (ADHD) and mothers' emotional symptoms.
  
  
  METHODS
  Fifty-three patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years) were included. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) for patients and controls. Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used to assess ADHD symptoms for patients. Mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables.
  
  
  RESULTS
  Children with epilepsy had a higher CSHQ Total score than the control group. Those with a CSHQ score >56 (which indicates moderate to severe sleep problems) had lower scores on KINDL-R. Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, STAI trait and Beck scores were found to be higher in those with a CSHQ score >56. Significant positive correlations were found between CSHQ Total score and T-DSM-IV-S, STAI trait and Beck scores. Binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score. None of the epilepsy-related variables were found to be related with the CSHQ Total score.
  
  
  CONCLUSIONS
  Among children with epilepsy, sleep problems lead to a poor quality of life. The link between sleep problems and psychiatric symptoms must be conceptualized as a bilateral relationship. ADHD appears to be the strongest predictor of sleep problems.
authors.affiliation: Child and Adolescent Psychiatry Department, Mersin University School of Medicine, Turkey. Electronic address: ozalpekinci@yahoo.com.
authors.forename: Ozalp
authors.initials: O
authors.lastname: Ekinci
authors.affiliation: Pediatrics Department, Division of Pediatric Neurology, Acıbadem University School of Medicine, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Isik
authors.affiliation: Child and Adolescent Psychiatry Department, Mersin University School of Medicine, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Gunes
authors.affiliation: Child and Adolescent Psychiatry Department, Mersin University School of Medicine, Turkey.
authors.forename: Nuran
authors.initials: N
authors.lastname: Ekinci
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D004827:Epilepsy / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data*; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology
keywords: ADHD; Anxiety; Children; Epilepsy; Sleep