SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XI. Pediatrics
Results: A total of 45 children among 49 affected with narcolepsy and
4 with idiopathic hypersomnia received modafinil. Mean age at onset of
treatment was 10.9±3.5 years (age range: 3-16 yo). The average daily
dose of modafinil was 388±158 mg (200 to 800mg). Duration of treatment
varied from 28 days to 10 years (mean 933±965 days). The mean
estimated improvement was 5.8±1.8 (self rating scale 0-9). Modafinil
was interrupted in 12 children because of lack of efficacy (9), excessive
cost (1), mild adverse effects (2). It was combined with other stimulants
in 8 children (stimulants 6 and sodium oxybate 2). There were no reported
adverse effects in 30/45 (66%) children. There were minor and
transient adverse effects in 12 (26%) children, including headache (3),
loss of appetite (2), dry mouth (2), irritability (1), tremor (1), hot flushes
(1), tongue protrusion (1), and increased cataplexy (1). Treatment was
interrupted due to an adverse effect in 2 children only.
Conclusion: Modafinil was first line treatment in 85% of narcoleptic
children in our cohort, showing a positive benefit/risk ratio in 75% of
the cases, with a mean duration of use of 3 years. No severe AE occurred
and most of the reported side effects were transient and benign.
In our pediatric cohort, Modafinil appeared to be safe, well tolerated and
effective.
Support (If Any): PHRC AOM07-138, French health Ministry; promotor:
Assistance Publique - Hôpitaux de Paris
0822
SLEEP DISORDERS IN THE SEVERELY MENTALLY
HANDICAPPED: A REPORT CONCERNING THE
REPERCUSSIONS FOR FAMILIES AND THE EXPERIENCES
OF HEALTH PROFESSIONALS
Franco P 1 , Rouzade C 2 , Lacau J 3 , Higgins S 4 , Desportes V 2
1
Pediatric Sleep Unit, HFME & INSERM U628, Lyon, France,
2
Department of Neuropediatrics, HFME, Lyon, France, 3 Reseau
Lucioles, Lyon, France, 4 Reseau Hypnor, Lyon, France
Introduction: The incidence of severe mental handicap in France is estimated
at 3-4/1000 live births. Sleep disorders are frequent and often
severe in this population of children. The aim of our study was to report
on the current situation of families with severely mentally handicapped
children and also medical staff who treat these children in France.
Methods: With the help of the Reseau Lucioles, we addressed an adapted
version of the Children’s Sleep Disturbance Scale (SDSC) questionnaire
to the families of severely mentally handicapped children in
France. We also distributed a questionnaire to paediatricians working
with the Centre d’Action Médico Sociale Précoce , which is a centre for
the prevention detection and treatment of mental handicap and also to
paediatric neurologists present at the French Society of Neuropediatricians
( SFNP) in 2010.
Results: We received replies from 292 families. The population was
made up of 75.9% children: 26.4% Angelman syndrome, 14.7% Rett
syndrome ,12% autistic disorders and 46.8% of other pathologies.
93.8% of the population who responded to the questionnaire stated that
their child suffered from sleep disturbances. 43.8% classified the trouble
as severe or very severe. We found a reported incidence of 70% concerning
sleep onset insomnia , 51% reporting short sleep duration , 60%
reporting night awakenings or sleep maintenance disorder, 12% with
sleep respiratory disturbance, and 35% with excessive daytime sleepiness.
Only 23% of people replying had found solutions to reported sleep
disorders. 94.3% of parents and 41.1% of siblings estimated that they
were “quite” or “very “ bothered by sleep problems presented by the
mentally handicapped member. We analysed 154 questionnaire replies
from medical doctors, who estimated that less than 50% of their patients
suffered from sleep disorders . They also expressed their difficulty in
diagnosing and treating such pathologies.
Conclusion: Our study highlights the need for progress in the management
of sleep disorders in the severely mentally handicapped children.
0823
SLEEP HYGIENE AND ACTIGRAPHICALLY EVALUATED
SLEEP CHARACTERISTICS IN CHILDREN WITH IN
CHILDREN WITH BENIGN CHILDHOOD EPILEPSY WITH
CENTROTEMPORAL SPIKES
Giannotti F, Cortesi F, Panunzi S, Cupellaro S, Ubertini C
Pediatrics & Develop Neuropsychiatry, Center of Pediatric Sleep
Disorders University of Rome La Sapienza, Rome, Italy
Introduction: Sleep problems are frequent in epileptic children. Although
several studies described the relationship between epilepsy and
sleep, no studies investigated sleep hygiene (SH) in these children. Aim
of this study is to investigate SH and sleep in children with Benign childhood
epilepsy with centrotemporal spikes (BCECTS) where it is generally
presumed that quality of life is not significantly affected.
Methods: A sample of 85 epileptic (mean age 7.6 years)and 182 typically
developing children (TD) (mean age 7.8 years) were investigated.
None of epileptics had frequent seizures and were drug-free. Parents
completed Children’s Sleep Hygiene Scale (CSHS, Harsh, 2001) and
Children’s Sleep Habits Questionnaire (CSHQ, Owens 2000). Sleep was
actigraphically evaluated for 7 consecutive nights.
Results: ANOVA results showed that epileptic children scored significantly
higher on CSHQ (Total 57 vs 43, Bedtime Resistance 10 vs
8, Night-Wakings 6 vs 3, Sleep Anxiety 8 vs 5, Parasomnias 12 vs 8,
Sleep Duration 5 vs 4,p