Epilepsy and sleep problems predict hyperactivity in Norwegian Angelman

Epilepsy onset at an earlier age and sleep problems independently predicted increased hyperactivity in Norwegians with Angelman syndrome, one study found.

“The results of this study may have potentially important implications for understanding the complex links between hyperactivity, sleep problems and early epilepsy in [Angelman syndrome]The scientists wrote.

The study, “Hyperactive behavior in Angelman syndrome: the association with sleep problems and the age of onset of epilepsy, ”Was published in the Intellectual Disability Research Journal.

Angelman syndrome is a genetic disorder characterized by developmental delays, intellectual disability, severe speech impairment, and a lack of coordinated muscle control (ataxia).

Sleep problems, such as abnormal sleep-wake cycles and a reduced need for sleep, are also found in Angelman’s syndrome, as is hyperactivity, which refers to constant body movements and an inability to rest. concentrate and focus.

Additionally, about 90% of Angelman patients experience epileptic seizures, which typically begin between 18 months and 2 years of age.

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Although sleep problems, hyperactivity, and epilepsy are more common in Angelman syndrome compared to other genetic diseases with severe intellectual disability, research on the links between these symptoms is limited.

Today, a collaborative team of researchers from Oslo University Hospital in Norway and King’s College London in the UK examined the relationship between sleep, hyperactivity and epilepsy in a group of Angelman patients. .

“The main objective of the present study was to explore the association between symptoms of hyperactivity, sleep problems and the age of onset of epilepsy in a sample of people with [Angelman syndrome]”the team wrote.

All known parents or guardians of people with Angelman syndrome in Norway were invited to participate in the study. A total of 25 men and 17 women with genetically verified Angelman, aged 2 to 57, were included. Information on epilepsy was gathered from medical records, while data on hyperactivity and sleep was obtained from questionnaires.

The Strengths and Difficulties Questionnaire (SDQ) was used to assess hyperactivity, which is a widely used behavioral screening test, and to assess people with Attention Deficit Hyperactivity Disorder (ADHD) – a condition defined by inattention, hyperactivity and impulsive behavior.

However, symptoms such as inattention are difficult to assess in people with language and intellectual disabilities, including those with Angelman. Thus, the team developed a separate assessment for hyperactivity solely based on the two elements of the SDQ: “restless, hyperactive and cannot stay still for long” and “constantly wiggling or squirming”. ADHD hyperactivity and symptoms were evaluated.

Another questionnaire assessed sleep disorders with an overall score based on three questions: “my child often wakes up in the middle of the night”, “when my child wakes up at night, it often takes a long time to fall asleep again”, and “my child sleeps less than his peers”.

The analysis found that worse sleep problems were significantly correlated with higher hyperactivity scores and ADHD symptoms in general, but not with the overall SDQ difficulty score.

The mean age of onset of epilepsy was 37 months (approximately 3 years), ranging from 3 to 94 months (approximately 8 years).

The onset of epilepsy at an earlier age was also correlated with more hyperactivity as well as symptoms of ADHD, while the onset of epilepsy was not associated with overall difficulties in SDQ or to sleep problems.

A more complex statistical model to measure the impact of age of onset of epilepsy and sleep problems on hyperactivity showed a significant relationship with each factor independently contributing to hyperactive behavior.

“Therefore, there was a tendency for both the earlier onset of epilepsy and more sleep problems to independently predict increased levels of hyperactivity in this sample,” the researchers wrote.

Further analysis of demographic factors showed that age, gender, presence of epilepsy, or type of genetic defect associated with Angelman did not affect hyperactivity, ADHD symptoms, or sleep problems.

Finally, compared to those who did not receive sleeping pills, patients taking these therapies were more likely to wake up during the night and tended to have more problems sleeping overall.

“It may be that the people who were prescribed the medication had particularly poor sleep and therefore could have achieved even higher results for sleep problems if they had not taken the medication. “, added the researchers.

“Our results suggest that the symptoms of hyperactivity, which are often prominent and severe in [Angelman syndrome], should be approached in conjunction with systematic sleep assessment to improve functional outcomes, ”the authors wrote.

“The results also indicate the possibility that successful treatment of sleep problems could reduce hyperactivity in people with [Angelman syndrome], and although the successful intervention of sleep problems in [Angelman syndrome] is difficult, targeted treatments may emerge in the future, ”they added.

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