Although sleep quality (SQ) reportedly affects the health-related quality of life (QOL) of patients with epilepsy, little is known about the potential association between SQ and QOL, particularly in children with epilepsy (CWE). Our study aimed to investigate the mediating effect of SQ on the QOL of CWE to obtain more information for the prevention and treatment of epilepsy in children. We collected general demographic and clinical data of 212 CWE and 79 controls (children who visited the Health Examination Department), and their guardians were instructed to answer the Children’s Sleep Habits Questionnaire (CSHQ) and the optimized Quality of Life in Childhood Epilepsy Questionnaire-16 (QOLCE-16). The -test, analysis of variance, chi-square test, and Fisher’s exact test were used for between group comparisons. The Pearson correlation was used to analyze the correlation between variables. The direct, indirect, and total effects of predictors on the QOL of CWE were estimated based on an adjusted mediation model. CWE had significantly smaller long-term urban residence rates, less educated guardians, higher total CSHQ score, higher incidence of poor SQ, higher bedtime resistance, more sleep anxiety, worse sleep-disordered breathing, increased parasomnia, more daytime sleepiness, more frequent night waking, and greater sleep onset delay than controls ( < 0.05 for all). The univariable analysis showed significant differences in total CSHQ scores between CWE with different seizure frequency in the last month, whether or not drug-resistant epilepsy (DRE), and with different video electroencephalogram (VEEG) findings ( < 0.05 for all). Differences in QOLCE-16 scores between CWE with different guardian’s employment status, age at diagnosis, number of anti-seizure medication (ASM) types, seizure frequency in the last month, DRE status, seizure type, VEEG findings, neuropsychological evaluation findings, magnetic resonance imaging (MRI) findings, and etiology were statistically significant ( < 0.05 for all). The correlation study indicated that the total CSHQ score was negatively correlated with the QOLCE-16 score ( < 0.05). The mediation analysis showed that DRE and VEEG abnormalities had a standardized direct effect on the QOL. Seizure frequency in the last month, DRE, and VEEG abnormalities had an indirect effect on the QOL through SQ, and their mediating effect values of SQ were 31.61 %, 13.45 %, and 14.35 %, respectively. Our findings uncovered the relationship of some clinical characteristics with SQ and QOL and characterized the nature of factors affecting the QOL of CWE. SQ could be a key factor in the prognosis of CWE experiencing epileptic seizures, and more attention should be paid on the management of SQ in interventions for epilepsy.

中文翻译：

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睡眠质量在癫痫儿童临床特征与生活质量之间的中介作用：来自西南地区的横断面研究

据报道，睡眠质量 (SQ) 会影响癫痫患者的健康相关生活质量 (QOL)，但人们对 SQ 和 QOL 之间的潜在关联知之甚少，尤其是癫痫儿童 (CWE)。本研究旨在探讨SQ对CWE QOL的中介作用，为儿童癫痫的预防和治疗提供更多信息。我们收集了 212 名 CWE 和 79 名对照者（到健康检查部门就诊的儿童）的一般人口统计和临床数据，并指导他们的监护人回答儿童睡眠习惯问卷 (CSHQ) 和优化的儿童癫痫生活质量问卷 16 （QOLCE-16）。组间比较采用χ检验、方差分析、卡方检验和Fisher精确检验。 Pearson相关性用于分析变量之间的相关性。根据调整后的中介模型估计了预测因素对 CWE 生活质量的直接、间接和总体影响。 CWE的长期城市居住率明显较低，监护人受教育程度较低，CSHQ总分较高，SQ不良发生率较高，睡前抵抗力较高，睡眠焦虑较多，睡眠呼吸障碍更严重，异态睡眠增多，白天嗜睡较多，夜间频繁与对照组相比，清醒和入睡延迟更长（所有<0.05）。单变量分析显示，上个月不同癫痫发作频率（无论是否为耐药性癫痫（DRE））以及不同视频脑电图（VEEG）结果的 CWE 总 CSHQ 评分存在显着差异（均 < 0.05）。不同监护人就业状况、诊断时年龄、抗癫痫药物（ASM）类型数量、上个月癫痫发作频率、DRE状态、癫痫类型、VEEG结果、神经心理学评估结果、磁性的CWE之间QOLCE-16评分的差异磁共振成像 (MRI) 结果和病因具有统计学意义（全部 < 0.05）。相关性研究表明，CSHQ 总分与 QOLCE-16 分呈负相关（<0.05）。中介分析表明 DRE 和 VEEG 异常对 QOL 有标准化的直接影响。近月癫痫发作频率、DRE、VEEG异常通过SQ对QOL产生间接影响，其SQ的中介作用值分别为31.61%、13.45%、14.35%。我们的研究结果揭示了一些临床特征与 SQ 和 QOL 的关系，并描述了影响 CWE QOL 的因素的性质。 SQ可能是癫痫发作的CWE预后的关键因素，在癫痫干预中应更加重视SQ的管理。