| Abstract [eng] |
Sleep disorders in children provide a frequent cause for parents to seek medical care. If a child has several kinds of sleep disorders and (or) has another illness, their diagnosis and treatment typically become more complicated. Sleep disorders are a frequent comorbidity to epilepsy. In the clinical practice, synthetic melatonin is prescribed for treatment of sleep disorders in children with epilepsy. Clinical trials suggest that melatonin may shorten the duration to sleep onset and balance the sleep structure, leading to decrease in the number of epileptic attacks. However, the melatonin system in these trials has not been explored, and changes of the melatonin system in children with epilepsy are not yet understood. The main objectives of the present study were: i) to determine the most frequent kinds of sleep disorders in children with epilepsy; ii) to characterize the melatonin (MLT) system in children with epilepsy in detail: to describe full diurnal profile, to search correlation with anthropometric data, seizure characteristics (time, type of seizures, antiepileptic medications), as well as the other physiological circadian rhythms (body temperature, pulse, blood pressure). The study results have shown that sleep disorders were more frequent in the group of children with epilepsy (Sleep disorders scale for children (SDSC) (Bruni O et al, 1996)).The most frequent were: the disorders of excessive somnolence (DOES) and sleep - wake transition disorders (SWTD). Melatonin metabolism (AUC/per kg body weight) had negative correlations with age and sexual maturity stage (Tanner stage) in each group separately and in pooled total group. The diurnal profiles of MLT secretion and excretion showed high inter-individual variability in both study groups. The circadian rhythms of salivary MLT secretion and excretion of metabolite 6-sulphatoxymelatonin (aMT6s), core body temperature, pulse, blood pressure were preserved in children with epilepsy. In the group of children with epilepsy, a subgroup of children had very high peak nocturnal salivary MLT concentrations (9/50; 18 %). MLT concentrations showed no associations with seizure characteristics. The study suggests that MLT system should be studied further in children with epilepsy and evaluated when treatment with melatonin is intended. |
