To examine sleep problems in a pediatric intracranial hypertension (IH) population.

There is a well-established association between headache disorders and sleep disturbances in children. Current literature that characterizes the relationship between sleep quality and primary (idiopathic) IH relates to obstructive sleep apnea (OSA), primarily through its association with obesity in adults. It is unknown if OSA plays a role in the pre-pubertal and non-obese populations with IH, and there is a paucity of literature describing the co-existence of other sleep disturbances in these patients.

Patients with IH who were newly diagnosed at Nationwide Children’s Hospital and followed in the Pediatric Intracranial Hypertension Clinic were recruited between July 2017 and September 2018. Demographic data was collected from the electronic medical record in addition to parent-completed questionnaires. Information on sleep behaviors was gathered from a validated survey, the Children’s Sleep Habits Questionnaire, and control data was obtained from questionnaires about patient siblings. Statistical analyses were performed using paired t-tests.

62 pairs of patients and matched sibling controls were compared. There was a statistically significant difference in total sleep disturbance score (control mean 44.3; patient mean 48.1; n=33 pairs, p=0.035) as well as subscale scores of sleep onset delay (control mean 1.4; patient mean 1.7; n=52 pairs, p=0.014), parasomnias (control mean 8.5; patient mean 9.5; n=42 pairs, p=0.013), and sleep disordered breathing (control mean 3.1; patient mean 3.4; n=44 pairs, p=0.013). There was no difference found in bedtime resistance, sleep duration, sleep anxiety, night wakings, and daytime sleepiness subscales. Furthermore, there was no difference in total sleep disturbance score between patient subsets including: primary versus secondary IH, obese versus non-obese, pre- versus post-pubertal, headaches versus headache-free, or treated versus untreated with medical therapy.

This observational study suggests that pediatric IH is associated with a modest increase in sleep disturbances.