Features of developmental coordination disorder and sleep difficulties in young adolescents with epilepsy: A case-controlled study

Objective: The primary aim was to compare the prevalence of difficulties with motor coordination and sleep in young adolescents with epilepsy (11–16 years) (n = 60) and a healthy control group (n = 49). The secondary aim was to explore factors associated with sleep and motor coordination in the epilepsy group.

Methods: Children with ‘active’ epilepsy, controls, and caregivers completed a measure of sleep (Insomnia Severity Index and Child Sleep Habits Questionnaire respectively). Caregivers also completed a measure of child motor coordination – Developmental Coordination Disorder (DCD) - Questionnaire (DCD-Q). Comparisons between the epilepsy and control group were undertaken using chi-square analysis and independent t-tests. Factors associated with sleep and motor coordination in children with epilepsy were explored using linear regression analysis. Alpha level was p < 0.05 and effect sizes are reported using Cohen’s d.

Results: The epilepsy and control group were matched on age, gender, and socioeconomic status. Children with epilepsy were significantly more likely to be at-risk for DCD than controls (45 % vs 12 %; p < 0.001). Children with epilepsy had more sleep difficulties than controls on self (p = 0.003; d = 0.581) and caregiver reports (p < 0.001; d = 1.230). Linear regression showed that the factors associated with DCD-Q scores on multivariable analysis were: age of seizure onset (p < 0.001), child mental health (p = 0.013), child sleep problems (p = 0.034), and epilepsy medication (p = 0.030). Children with a younger age of epilepsy onset, with more self-reported mental health problems, on polypharmacy and experiencing more sleep problems had increased DCD-Q scores. Regarding child-reported sleep, children with more sleep difficulties had a significantly greater degree of reported DCD features (p < 0.001).

Significance: Young adolescents with epilepsy should be screened for sleep and motor coordination difficulties. Future research should focus on interventions to support children with epilepsy to reduce the impact of these difficulties on everyday functioning.