Sleep Abnormalities and Sleep Breathing Disorders in Children with Drug- Resistant Catastrophic Epileptic Encephalopathy

Abstract

Undiagnosed obstructive sleep apnoea is common in patients with medically refractory epilepsy. The aim of this study is to evaluate sleep alterations and the prevalence of Sleep Breathing Disorders (SBD) in a paediatric population with catastrophic epileptic encephalopathy. To diagnose SBD, polysomnography (PSG) was performed in eleven patients (nine males, two females), with ages ranging between 3 and 11 years old, with epileptic encephalopathy characterized by drug-resistant seizures, occurring both in sleeping and waking, mental retardation and cerebral palsy. All the patients presented alterations of the sleep architecture and were positive for SBD. In particular, seven patients presented a severe form of Obstructive Sleep Apnoea Syndrome (OSAS) with apnoea/ hypopnea index (AHI) greater than10/hr, two patients presented a moderate form with AHI between 5/hr and 10/hr, two patients presented a mild form with AHI lower than 4/hr. In conclusion, SBD and sleep disruption appeared to be in comorbidity with catastrophic epileptic encephalopathy. Their treatment might also have a positive impact in seizures control and quality of life.