Sleep Disorders Five Years After Acute Provoked Neonatal Seizures

Renée A Shellhaas; Linda S Franck; Betsy Pilon; Courtney J Wusthoff; Shavonne L Massey; Catherine J Chu; Janet S Soul; Monica E Lemmon; Adam L Numis; Julie S Sturza; Cameron Thomas; Giulia M Benedetti; Stephanie M D Rau; Tayyba Anwar; Madison M Berl; Charles E McCulloch; Hannah C Glass

doi:10.1016/j.jpeds.2024.114412

Sleep Disorders Five Years After Acute Provoked Neonatal Seizures

J Pediatr. 2024 Nov 17:278:114412. doi: 10.1016/j.jpeds.2024.114412. Online ahead of print.

Authors

Renée A Shellhaas¹, Linda S Franck², Betsy Pilon³, Courtney J Wusthoff⁴, Shavonne L Massey⁵, Catherine J Chu⁶, Janet S Soul⁷, Monica E Lemmon⁸, Adam L Numis⁹, Julie S Sturza¹⁰, Cameron Thomas¹¹, Giulia M Benedetti¹⁰, Stephanie M D Rau¹⁰, Tayyba Anwar¹², Madison M Berl¹³, Charles E McCulloch¹⁴, Hannah C Glass¹⁵

Affiliations

¹ Department of Neurology, Washington University School of Medicine, St Louis, MO. Electronic address: [email protected].
² Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, CA; Department of Family Health Care Nursing, University of California, San Francisco, CA.
³ Hope for HIE, West Bloomfield, MI.
⁴ Department of Neurology, University of California, Davis, Sacramento, CA.
⁵ Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
⁶ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
⁷ Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
⁸ Departments of Pediatrics and Population Health Sciences, Duke University, School of Medicine, Durham, NC.
⁹ Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, CA; Department of Neurology and Weill Institute for Neuroscience, University of California, San Francisco, CA.
¹⁰ Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI.
¹¹ Division of Neurology, Department of Pediatrics, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
¹² Division of Neurology, Children's National Hospital, Washington, DC.
¹³ Division of Neuropsychology, Children's National Hospital, Washington, DC.
¹⁴ Department of Epidemiology & Biostatistics University of California, San Francisco, CA.
¹⁵ Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, CA; Department of Neurology and Weill Institute for Neuroscience, University of California, San Francisco, CA; Department of Epidemiology & Biostatistics University of California, San Francisco, CA.

PMID: 39557387
DOI: 10.1016/j.jpeds.2024.114412

Abstract

Objective: To evaluate whether abnormal sleep is associated with adverse outcomes for children who survived acute provoked neonatal seizures, and their parents.

Study design: This 9-center study prospectively followed newborns with acute provoked seizures. When children reached age 5 years, parents completed the Children's Sleep Habits Questionnaire (CSHQ), the Pediatric Sleep Questionnaire-Sleep Related Breathing Disorders (PSQ-SRBD) subscale, the Vineland Adaptive Behavior Scales-3, and the Hospital Anxiety Depression Scale. Children were also assessed with the Wechsler Preschool and Primary Scale of Intelligence-IV (WPPSI-IV). Spearman correlations and multivariable analyses were used to evaluate risk factors for sleep problems.

Results: The mean CSHQ score was 45 ± 7; 77 of 118 children (65%) had an abnormal score (above the healthy sleep threshold of 41). On the PSQ-SRBD, 32 of 119 children (27%) screened positive for sleep-disordered breathing (SDB). SDB symptoms were more common among children with cerebral palsy (42% with vs 22% without; P = .03) and epilepsy (54% with vs 24% without; P = .02). Children with lower scores on the Vineland-3 (rho = -0.25; P = .01) and WPPSI-IV (rho = -0.31; P = .004) at 5 years of age were more likely to have symptoms of SDB. Worse CSHQ and PSQ-SRBD scores were associated with higher parental anxiety (rho = 0.28 [P = .002] and rho = 0.34 [P = .0002], respectively) and depression scores on the Hospital Anxiety Depression Scale (rho = 0.16 [P = .08] and rho = 0.17 [P = .07], respectively).

Conclusions: Two-thirds of early school-aged survivors of acute provoked neonatal seizures had parent-reported sleep abnormalities and one-quarter screened positive for SDB. Early screening and effective treatment for sleep disorders could be an innovative, practice-changing approach to improve outcomes after neonatal seizures.