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

Abstract Aims Attention-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. Methods 53 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. Results Children 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. Discussion Epilepsy–ADHD is associated with a significantly poor sleep quality which is beyond that of primary ADHD and epilepsy.