Characterized at its extreme by physical convulsions, epilepsy has long been thought to cause excitability and contrariness in children. But UF researchers writing in the journal Epilepsy & Behavior believe the real reason some of these children cannot sit still or pay attention is because they don't get enough shut-eye.
“When we treated kids with sleep disturbances, not only did their epilepsy get better, their daytime behavior, concentration and capacity to learn increased,” said Paul Carney, M.D., chief of pediatric neurology at UF's College of Medicine and a professor at the B.J. and Eve Wilder Center for Excellence in Epilepsy Research . “Many kids with epilepsy aren't being adequately assessed for underlying sleep disorders. We can significantly have an impact over their cognition, learning and maybe even improve their epilepsy by improving their sleep.”
Epilepsy describes a group of disorders that occur when electrical activity in the brain goes haywire, resulting in bursts of frenetic activity that cause seizures. It strikes more than 2 million people in the United States, according to the National Institute of Neurological Diseases and Stroke.
UF scientists monitored the brain and muscular activity of 30 children with epilepsy between the ages of 7 and 14 during single overnight stays. None of the children had seizures, but some awoke hundreds of times because of breathing problems.
In all, 24 of the children — 80 percent — breathed shallowly or had breathing disruptions caused by apneas, which usually happen when the soft tissue in the rear of the throat relaxes during sleep and blocks a person's airway.
As the breathing disruptions increased in duration, the children spent less time in rapid eye movement, or REM, sleep, a period in the sleep cycle when brain activity is highest and people dream intensely. The children in the study spent 17 percent of total sleep time in the REM stage. The norm for young adults is 25 percent.
“Removing the sleep problem does seem to improve the behavior problem significantly, because it changes the child's level of alertness,” Carney said. “Commonly, adults are just not as awake if they have a sleep disorder. But children who haven't taken their nap are wound up instead. Treating their sleep disorder, we think, can enable their brain to have some control over unwanted behavior.”
Seventy-three percent of the children studied — 22 of the 30 — met clinical criteria for inattention or hyperactivity, according to Carney, who conducted the research with Eileen Fennell, Ph.D., a child neuropsychologist in the College of Public Health and Health Professions, and Danielle Becker, M.S., a former graduate student now pursuing a medical degree.