Sleep problems in pediatric epilepsy and ADHD: The impact of comorbidity

- Children with epilepsy-ADHD had the highest CSHQ total scores, followed by children with primary ADHD and those with epilepsy.
- The frequency of moderate-severe sleep problems was highest (62.9%) in children with epilepsy-ADHD.
- Children with epilepsy-ADHD differed from other groups with higher subscores on sleep onset delay and sleep anxiety.
- No ADHD subtype difference was found on CSHQ total scores.
- Epilepsy-related variables were not found to be associated with CSHQ scores.

AimsAttention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD.Methods53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ). Neurology clinic charts were reviewed for the epilepsy-related variables. ADHD subtypes were diagnosed according to the DSM-IV.ResultsChildren with epilepsy-ADHD had the highest CSHQ total scores, while children with primary ADHD had higher scores than those with epilepsy. Besides the total score, epilepsy-ADHD group differed from the primary ADHD and epilepsy groups with higher CSHQ subscores on sleep onset delay and sleep anxiety. The frequency of moderate-severe sleep problems (CSHQ > 56) was 62.9% in children with epilepsy-ADHD, while it was 40.4% and 26.4% in children with primary ADHD and epilepsy, respectively. CSHQ total scores were not different between ADHD subtypes in both children with epilepsy-ADHD and those with primary ADHD. None of the epilepsy-related variables were found to be associated with CSHQ scores.DiscussionEpilepsy-ADHD is associated with a significantly poor sleep quality which is beyond that of primary ADHD and epilepsy.