Epilepsy: are night-time breathing problems disrupting children’s sleep?
Published on 25 July 2016
Over 60,000 children and young people aged 18 and under have epilepsy in the UK.1 Dr Don Urquhart, of Edinburgh’s Royal Hospital for Sick Children, is investigating suggestions that children with epilepsy are unusually susceptible to breathing problems at night because of a disorder called obstructive sleep apnoea (OSA). If it’s spotted, OSA can almost always be treated, but when it’s missed, it disturbs children’s sleep and can lead to problems with growth, learning and behaviour. Better diagnosis and treatment of OSA in children with epilepsy may prevent unnecessary suffering.
How are children’s lives affected now?
Children with OSA stop breathing for a few seconds at a time during their sleep. This happens when the walls of the throat relax, blocking the flow of air. Oxygen levels in the blood fall and may cause children to wake up briefly and start breathing again, often gasping or snorting as they do so.
Children tend to go back to sleep so quickly that they usually don’t remember waking up and parents may not notice what’s happening during the night.
OSA can almost always be treated, but if undiagnosed it may affect children’s health and their quality of life: “When children have OSA, their breathing can be interrupted many times a night, which can severely disturb their sleep,” says Dr Urquhart. “This sleep disruption is thought to be the reason why, if left untreated, children with OSA can have daytime symptoms too, such as difficulties paying attention and problems with learning and behaviour. Children can also have high blood pressure and poor growth.”
How could this research help?
The team is investigating whether children with epilepsy are more likely to have OSA than other children.
Overall, it’s thought that up to six per cent of children have OSA, but preliminary evidence suggests that number is much higher in children with epilepsy – possibly as high as 55 per cent– and Dr Urquhart aims to find out more about whether that’s true.2,3
“Children with epilepsy often have learning problems,” says Dr Urquhart. “If children with epilepsy also have OSA, and their OSA is going undiagnosed and untreated, this might be contributing to their learning problems and treatment might help to counter that.”
“If our results show children with epilepsy are prone to having OSA, we plan further work to assess the effects of treatment,” adds Dr Urquhart. “The benefits of detecting and treating OSA in children without epilepsy are already well-established, with improvements in, for example, learning and quality of life.”
1. Joint Epilepsy Council of the UK and Ireland. Epilepsy prevalence, incidence and other statistics. September 2011. http://www.epilepsyscotland.org.uk/pdf/Joint_Epilepsy_Council_Prevalence_and_Incidence_September_11_(3).pdf
2. Marcus CL et al. Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics 2012;130:576–584. http://pediatrics.aappublications.org/content/130/3/576 Website accessed 14 July 2016.
3. Urquhart DS et al. Observational pilot study of reported symptoms of Obstructive Sleep Apnoea (OSA) in children with epilepsy and healthy controls. Dev Med Child Neurol 2016; Jun 18. doi: 10.1111/dmcn.13173. [Epub ahead of print]
|Project Leader||Dr Don S Urquhart MD FRCPCH|
|Location||Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh|
|Grant awarded||21 June 2016|
|Start date||1 March 2017|
|End date||31 August 2019|
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