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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03103841
Other study ID # GN2392
Secondary ID
Status Completed
Phase
First received
Last updated
Start date March 31, 2017
Est. completion date December 31, 2022

Study information

Verified date April 2022
Source NHS Lothian
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Obstructive sleep apnoea (OSA) is a condition that affects around one in 20 children. In children with OSA, repeated episodes of airway obstruction can severely disturb and fragment sleep, leading to subsequent cognitive and behavioural problems . Epilepsy affects 60,000 children in the UK and up to 30% of children with epilepsy have learning problems. Evidence suggests that OSA is more common in children with epilepsy, such that sleep disturbance could account for some of the learning problems they experience. The aim of this study is to determine the prevalence of OSA in children with epilepsy. The investigators plan carry out detailed sleep studies in children with epilepsy and healthy controls to determine if children with epilepsy are more likely to have OSA than healthy children of the same age. OSA is almost always treatable and the benefits of detecting and treating the condition in healthy children are well-established. If OSA proves to be a common finding in children with epilepsy, it will be important to carry out further studies to see if treating the condition has beneficial effects on learning and behaviour. This project could lead doctors to target sleep-disordered breathing as a way of improving learning outcomes in children with epilepsy.


Description:

Obstructive sleep apnoea (OSA) is a condition that affects around one in 20 children. In OSA, the muscles and soft tissues in the throat relax and collapse during sleep causing the upper airway to become blocked. Breathing is briefly interrupted, blood oxygen levels fall and this causes the child to wake and start breathing again. These episodes can happen many times a night causing severely disturbed sleep. Untreated OSA may leave children with daytime attention difficulties and problems with learning and behaviour. Epilepsy affects approximately 60,000 children in the UK and up to 30 per cent of these children have associated learning problems. There is evidence, including pilot work undertaken by the study team to suggest that OSA is more common in children with epilepsy, in which case, sleep disturbance could account for some of the learning problems they experience. The aim of this study is to determine the prevalence of OSA in children with epilepsy. The investigators plan to carry out detailed polysomnography sleep studies in 55 children with epilepsy and 28 healthy children (controls). These studies will measure the length and quality of sleep over one night spent at the hospital. Seizure activity during this period will be monitored by video recordings combined with electroencephalograms (EEG). Sleep-disordered will be assessed using a variety of tests to measure air-flow, lung expansion and blood oxygen levels. This study should help to determine if children with epilepsy are more likely to have OSA than healthy children of the same age. OSA is almost always treatable and the benefits of detecting and treating the condition in healthy children are well-established. If OSA proves to be a common finding in children with epilepsy, it will be important to carry out further studies to see if treating the condition has beneficial effects on learning and behaviour. This project could lead doctors to target sleep-disordered breathing as a way of improving learning outcomes in children with epilepsy. Children with epilepsy attending Royal Hospital for Children, Edinburgh will be invited to take part in the study. Children without epilepsy (controls) will also be recruited. The children without epilepsy are included because although there are statistics for incidence of OSA in the general population, information for all the measures of sleep the team will collect are not available. The study will assess sleep time, sleep efficiency, sleep architecture and respiratory events in children with epilepsy and control subjects. To be sufficiently powered, it is planned to test 50 children with epilepsy and 25 healthy controls. A sleep physiologist will work with participants to measure: - Polysomnography (to record body functions in sleep - airflow in and out of the lungs, oxygen level in the blood, body position, breathing effort and rate, electrical activity of muscles, eye movement and heart rate) - EEG or electroencephalography (to measure the electrical activity of the brain), - Electrooculography (to measure rapid eye movements along horizontal and vertical axes), - Chin electromyogram (to measure electrical impulses to chin muscles), - Sleep quality. A neurologist and physiologist will assess seizure frequency and discharges between seizures, and epilepsy types using video EEG monitoring. Further information will be collected: height, weight, body mass index, antiepileptic medication use, tonsillar size, Mallampati score (a measure of base of tongue to hard palate), completion of sleep questionnaires by participants and their parents, to include sleepiness scales and sleep quality index.


Recruitment information / eligibility

Status Completed
Enrollment 72
Est. completion date December 31, 2022
Est. primary completion date October 31, 2022
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 5 Years to 18 Years
Eligibility Inclusion Criteria: - Diagnosis of primary epilepsy and attendance at Epilepsy clinic Exclusion Criteria: - Neurological co-morbidity affecting muscle tone OR any Respiratory co-morbidity including any history of asthma, airborne allergy or sleep-disordered breathing.

Study Design


Intervention

Procedure:
Sleep studies [Polysomnography]
Undertaking of sleep measurements by polysomnography and use of validated sleep questionnaires

Locations

Country Name City State
United Kingdom Royal Hospital for Sick Children Edinburgh

Sponsors (3)

Lead Sponsor Collaborator
NHS Lothian Action Medical Research, University of Edinburgh

Country where clinical trial is conducted

United Kingdom, 

References & Publications (1)

Urquhart DS, Hill EA, Hill LE, Carruthers E, McLellan AE, Chin R, Shetty J. Adults with epilepsy appear to differ from children in regard to daytime sleepiness. J Clin Sleep Med. 2020 Aug 15;16(8):1393-1394. doi: 10.5664/jcsm.8528. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Other Presence of epileptiform discharges during sleep As measured on sleep EEG Single point in time measurement - Sleep study [8 to 10 hour period of sleep data]
Primary Apnea/Hypopnea index Measurement of presence and severity of obstructive sleep apnoea Over study duration - 2 years
Secondary Total Sleep Time As measured on sleep study Over study duration - 2 years
Secondary Sleep Efficiency Used to quantify sleep fragmentation i.e. %time asleep out of total study time Over study duration - 2 years
Secondary Sleep Quality Pittsburgh Sleep Quality Index questionnaire Up to 10 hours
Secondary Symptoms of OSA PSQ-SRBD scale questionnaire Over study duration - 2 years
Secondary Daytime Sleepiness Epworth Sleepiness Score questionnaire Over study duration - 2 years
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