Sleep disruption in children and adolescents with epilepsy: A systematic review and meta-analysis

Alice A. Winsor*, Caroline Richards, Stacey Bissell, Stefano Seri, Ashley Liew, Andrew P. Bagshaw

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


This systematic review and meta-analysis aims to assess and quantify putative differences in sleep architecture, sleep efficiency, sleep timing and broadly-defined sleep difficulties between children with and without epilepsy. Databases were searched systematically, and studies identified in PubMed, EMBASE, PsychINFO and Medline. The meta-analysis included 19 studies comparing a total of 901 children with epilepsy to 1470 healthy children. Relative to healthy children, children with epilepsy experienced reduced sleep time, sleeping on average 34 mins less across self-report, actigraphy, 24-h video-EEG and polysomnography measures. They had more sleep difficulties specifically in the domains of night waking, parasomnias and sleep disordered breathing. The analysis also revealed a significantly increased percentage of N2 sleep and decreased sleep efficiency in children with epilepsy compared to healthy children. These results illustrate that children with epilepsy are vulnerable to more sleep difficulties compared to healthy children. This suggests that screening for sleep difficulties should be an integral part in a diagnosis of epilepsy to ensure that clinically relevant sleep difficulties are identified and treated. Such an approach may ultimately aid in the development of treatment strategies which can contribute to improvements in both developmental and diagnostic outcomes for children with epilepsy.

Original languageEnglish
Article number101416
Number of pages14
JournalSleep Medicine Reviews
Early online date19 Jan 2021
Publication statusPublished - Jun 2021

Bibliographical note

Copyright © 2021 Elsevier Ltd. This accepted manuscript version is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License [].

Funding & Acknowledgements:
This work was supported by The Waterloo Foundation .


  • Adolescents
  • Children
  • Epilepsy
  • Meta-analysis
  • Sleep


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