Sleep Macro- and Microstructure Is Altered in Children with Epilepsy

Background/Purpose: Sleep and epilepsy are connected in a complex and bidirectional way. Studies about alterations of sleep macro- and microstructure in children with epilepsy are sparse. We aimed to compare the macro- and microstructure of children with epilepsy to a healthy control group regarding number and duration of sleep slow waves (SW) as well as coupling between SW and sleep spindles during non-rapid eye movement (NREM) sleep.

Methods: Polysomnography recordings of 14 consecutive children with diagnosed epilepsy (8 females; mean age 9.36 ± 3.43 years) and 11 healthy controls (8 females; mean age 11.82 ± 2.64 years) were obtained from the database of the Children's Hospital Kaufbeuren. Slow waves were automatically detected with a validated detector. Rate and duration of SW as well as the SW-spindle-coupling were compared between the groups in the beginning and at the end of the night.

Results: Regarding sleep macrostructure, % of rapid eye movement (REM) sleep was reduced and wake after sleep onset (WASO) increased in children with epilepsy. SW rates were higher in children with epilepsy compared with the control group (7.06 [1.80; 23.37] vs. 4.30 [0.74; 12.31], p = 0.029, r = 0.44). Both rates of spindle-coupled (7.06 [0.90; 23.37] vs. 0.50 [0.18; 1.01], p < .,0005, r = 0,83) and not spindle-coupled SW (8.85 [0.85; 22.78] vs. 3.66 [0.35; 11.31], p = 0.019, r = 0.42) were significantly higher in children with epilepsy compared with controls.

Conclusion: Children with epilepsy show altered rates of SW which play an important role in memory consolidation. Increased SW rates in children with epilepsy may be because of enhanced pathological slowing. Future studies shall focus on detangle pathological and physiological slowing to potentially explain cognitive impairment in children with epilepsy.

Publication History

Article published online:
13 November 2023