OBJECTIVE To assess physical activity and sleep rates in a cohort of children with epilepsy (CWE) and determine if there is a relationship between physical activity and sleep time. METHODS Children aged 8-14 years with a diagnosis of epilepsy and at least one seizure in the past 12 months were monitored via a wrist-worn activity tracker for 16 weeks, to objectively measure daily physical activity, as assessed by step counts, and sleep time. Adherence to physical activity (≥12,000 steps/day) and sleep recommendations (≥9 h for children aged 8-12 years, or ≥8 h for children aged 13-15 years) was determined. To predict daily activity or nightly sleep, a series of multivariable models incorporating age, sex, day-type (all combinations of weekday or weekend and summer holiday or school), participant (as a random effect), daily physical activity (for models predicting sleep), nightly sleep (for models predicting physical activity), and autoregressive terms of previous sleep or physical activity were constructed, and the best-performing models were selected with Akaike information criterion analysis. RESULTS Twenty-two children with mild to moderate epilepsy were recruited (54.5% female, median (IQR) age 11 (10, 13) years) and monitored for 16 weeks. They met the recommended level of physical activity only in 38.0% (21.7%, 59.4%), and sleep in 49.1% (30.0%, 68.5%) of days. They met both physical activity and sleep guidelines on the same day in only 17.8% (95% CI 7.1%, 38.0%). There was no association between meeting the recommended levels of daily physical activity and sleep time (p = 0.86, ρ = 0.03). In the best-performing model, age, sex, day type, and participant explained 28.9% of the variance in daily physical activity, with no additional insight provided by measures of sleep time. Age, sex, day type, participant, and daily physical activity explained 17.3% of the variance in nightly sleep time, with a statistically discernable but small association between physical activity and sleep time (1.79 ± 0.53, p = 0.001). CONCLUSION Our cohort of children with mild to moderate epilepsy showed poor adherence to sleep and physical activity guidelines. There was no clinically relevant association between daily physical activity and sleep among these children who were similarly active to healthy peers. Future studies should assess the effect of increased sleep hygiene and physical activity on overall well-being and seizure control in CWE.

中文翻译：

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癫痫患儿对睡眠和体力活动指南的依从性差

目的 评估一组癫痫 (CWE) 儿童的体力活动和睡眠率，并确定体力活动与睡眠时间之间是否存在关系。方法 8-14 岁在过去 12 个月内被诊断为癫痫且至少有一次癫痫发作的儿童通过腕带活动追踪器监测 16 周，以客观地测量每天的体力活动，通过步数和睡眠进行评估。时间。确定坚持体育活动（≥12,000 步/天）和睡眠建议（8-12 岁儿童≥9 小时，或 13-15 岁儿童≥8 小时）。为了预测日常活动或夜间睡眠，一系列多变量模型包括年龄、性别、日期类型（工作日或周末和暑假或学校的所有组合）、参与者（作为随机效应）、构建每日体力活动（用于预测睡眠的模型）、夜间睡眠（用于预测体力活动的模型）和先前睡眠或体力活动的自回归项，并通过 Akaike 信息准则分析选择表现最佳的模型。结果 招募了 22 名患有轻度至中度癫痫的儿童（54.5% 为女性，中位 (IQR) 年龄为 11 (10, 13) 岁）并监测了 16 周。他们仅在 38.0% (21.7%, 59.4%) 和 49.1% (30.0%, 68.5%) 天的睡眠中达到推荐的体力活动水平。只有 17.8% (95% CI 7.1%, 38.0%) 的人在同一天同时符合体育活动和睡眠指南。达到推荐的每日体育活动水平与睡眠时间之间没有关联（p = 0.86，ρ = 0.03）。在表现最好的模型中，年龄、性别、日期类型、参与者解释了日常身体活动中 28.9% 的差异，而没有通过睡眠时间测量提供额外的洞察力。年龄、性别、白天类型、参与者和日常体力活动解释了夜间睡眠时间差异的 17.3%，体力活动与睡眠时间之间存在统计学上可辨别但很小的关联 (1.79 ± 0.53, p = 0.001)。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动与睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。没有通过测量睡眠时间提供额外的洞察力。年龄、性别、白天类型、参与者和日常体力活动解释了夜间睡眠时间差异的 17.3%，体力活动与睡眠时间之间存在统计学上可辨别但很小的关联 (1.79 ± 0.53, p = 0.001)。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动与睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。没有通过测量睡眠时间提供额外的洞察力。年龄、性别、白天类型、参与者和日常体力活动解释了夜间睡眠时间差异的 17.3%，体力活动与睡眠时间之间存在统计学上可辨别但很小的关联 (1.79 ± 0.53, p = 0.001)。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动与睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。夜间睡眠时间的差异为 3%，体力活动与睡眠时间之间存在统计学上可辨别但很小的关联 (1.79 ± 0.53，p = 0.001)。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动与睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。夜间睡眠时间的差异为 3%，体力活动与睡眠时间之间存在统计学上可辨别但很小的关联 (1.79 ± 0.53，p = 0.001)。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动与睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动与睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。结论 我们的轻度至中度癫痫儿童队列显示对睡眠和身体活动指南的依从性较差。在这些与健康同龄人一样活跃的儿童中，日常体力活动和睡眠之间没有临床相关的关联。未来的研究应该评估增加睡眠卫生和身体活动对 CWE 整体健康和癫痫控制的影响。