Sleep Disorders in Pediatric Epilepsy

Sleep disturbances are among the most common and impactful comorbidities in children with epilepsy, affecting up to two-thirds of this population. Presentations range from difficulty initiating and maintaining sleep to parasomnias and disruptions of rapid eye movement and non-rapid eye movement sleep cycles. A complex, bidirectional relationship exists whereby epileptic activity fragments sleep architecture and, conversely, poor sleep quality can exacerbate seizure frequency and severity. Antiseizure medications may further alter sleep patterns, while underlying neurodevelopmental vulnerabilities amplify cognitive and behavioural sequelae. Persistent sleep problems in early life are linked to deficits in attention, learning and emotional regulation, with measurable consequences for academic performance and family wellbeing. Recognition of sleep disorders as integral to epilepsy management has led to calls for routine sleep assessment, multidisciplinary care pathways and the development of tailored behavioural and pharmacological interventions designed to improve both seizure control and overall quality of life.

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Sleep Disorders in Pediatric Epilepsy publication trend

The graph below shows the total number of articles in sleep disorders in pediatric epilepsy across all publications each year (not limited to Nature Index journals).

Technical terms

Comorbidity: The simultaneous presence of two or more medical conditions, such as epilepsy and a sleep disorder, in the same individual.

Sleep architecture: The organisation of sleep into cyclical stages—light sleep, deep sleep and rapid eye movement sleep—across a single sleep period.

Behavioural sleep intervention: A structured programme using educational and behavioural techniques to improve sleep habits and patterns without medication.

Sleep latency: The interval between intended bedtime and the onset of sleep, often prolonged in insomnia.

Developmental and epileptic encephalopathy: A group of severe epilepsy syndromes in infancy or childhood characterised by refractory seizures and progressive neurodevelopmental impairment.

Rolandic epilepsy: A common focal epilepsy of childhood, typically benign, involving seizure activity in the centrotemporal region of the brain.

References

1. The Relationship Between Sleep, Cognition and Behavior in Children With Newly-Diagnosed Epilepsy Over 36 Months. Frontiers in Neurology (2022).
2. Characterizing Sleep Phenotypes in Children With Newly Diagnosed Epilepsy. Pediatric Neurology (2022).
3. Changing Agendas on Sleep, Treatment and Learning in Epilepsy (CASTLE) Sleep-E: a protocol for a randomised controlled trial comparing an online behavioural sleep intervention with standard care in children with Rolandic epilepsy. BMJ Open (2023).