0921 Rest–Activity Chronotype and Sleep Disturbances in Children with Epilepsy

Abstract Introduction Children with epilepsy experience higher rates of sleep disturbances than their healthy peers, which may adversely affect seizure control and daytime functioning. Chronotype, reflecting individual differences in circadian phase, has been shown to influence sleep timing and quality in pediatric populations. However, limited research has examined how chronotype, as indexed by objective rest–activity patterns, relates to caregiver-reported sleep problems in children with epilepsy. Methods In this ongoing cross-sectional study, 37 child–caregiver dyads (children aged 1.5–9 years) were recruited from a pediatric neurology clinic in northern Taiwan. Caregivers completed demographic questionnaires and the Children’s Sleep Habits Questionnaire (CSHQ). Children wore wrist actigraphy devices continuously for seven consecutive days. Chronotype was estimated using the actigraphy-derived acrophase of the 24-hour rest–activity rhythm. Results The mean acrophase time was 14:38 ± 0:54. The average CSHQ total score was 52.19 ± 7.59, with 94.6% of children (n = 35) scoring above the clinical cutoff of 41, indicating a high prevalence of sleep difficulties. Later acrophase times were significantly correlated with higher CSHQ subscale scores for sleep duration problems (r = .47, p < .01), parasomnias (r = .36, p = .03), and sleep-disordered breathing (r = .47, p < .01). Earlier acrophase times were associated with longer daily sleep duration measured by actigraphy (r = –.43, p < .01). In multivariable linear regression models adjusting for relevant covariates, later acrophase remained a significant predictor of greater sleep duration problems (β = .45, p = .01) and sleep-disordered breathing (β = .55, p < .01). Conclusion A later chronotype, as reflected by delayed rest–activity acrophase, was associated with greater caregiver-reported sleep problems and shorter objective sleep duration in children with epilepsy. These findings suggest that circadian timing may play an important role in sleep health in this population. Interventions supporting earlier and more stable sleep–wake schedules may help mitigate sleep-related difficulties. Future studies with larger samples and longitudinal designs are needed to better understand factors influencing chronotype and its clinical implications in pediatric epilepsy. Support (if any) This study was supported by the National Science and Technology Council, Taiwan, NSTC113-2314-B002-131-MY3