Tesis

Gangguan Tidur pada Anak dengan Epilepsi dan Faktor – Faktor yang Memengaruhinya = Sleep Disorder in Children with Epilepsy and Factors-Associated.

Latar belakang : Tidur berguna untuk kesehatan mental, emosi, fisik, dan sistem imunitas tubuh. Gangguan tidur pada anak semakin menjadi masalah karena akan berdampak pada mood, perilaku dan intelektual anak. Dilaporkan, insidensi gangguan tidur pada anak lebih tinggi pada kasus epilepsi. Tujuan : Mengetahui prevalensi gangguan tidur pada anak dengan epilepsi, serta menilai hubungan antara faktor – faktor risiko yang memengaruhinya kejadian gangguan tidur pada anak dengan epilepsi. Metode : Studi potong lintang yang dilakukan di Poliklinik Anak Kiara RS Cipto Mangunkusumo Jakarta dengan populasi anak epilepsi usia 4-18 tahun. Penilain variabel gangguan tidur menggunakan kuesioner sleep disturbance scale for children (SDSC) terdiri dari 26 pertanyaan yang telah tervalidasi sebelumnya. Kuesioner akan diisi oleh orang tua mengenai pola tidur anak dalam 6 bulan terakhir. Pasien yang sebelumnya memiliki gangguan tidur primer seperti obstructive sleep apnea (OSA), sindrom epilepsi, disabilitas intelektual, attention deficit hyperactivity disorder (ADHD) akan dieksklusi. Hasil : Didapatkan 99 subyek dengan karakteristik 22,2% menderita epilepsi intraktabel, 28,2% serebral palsi dan 64,6% tipe kejang umum. Dari hasil kuisioner SDSC didapatkan 71,7% anak dengan epilepsi mengalami gangguan tidur, jenis terbanyak 62% gangguan memulai dan mempertahankan tidur. Faktor risiko yang terbukti memengaruhi secara independen kejadian gangguan tidur pada pasien epilepsi adalah tipe kejang umum, serebral palsi, epilepsi intraktabel, elektroensefalografi (EEG) abnormal, dan obat antiepilepsi (OAE) jenis nonbenzodiazepin. Kesimpulan : Tipe kejang umum, serebral palsi, epilepsi intraktabel, abnormalitas EEG, dan OAE jenis non-benzodiazepin bermakna secara statistik independen memengaruhi kejadian gangguan tidur pada epilepsi.
Kata Kunci : gangguan tidur, epilepsi, faktor risiko, anak, sleep disturbance scale for children (SDSC)


Background : Sleep is affecting mental health, emotional, physical, and immune system. Sleep disorder in children was increased and became a burden because it will affect the mood, behaviour and intellectual. Reportedly, the incidence of sleep disorder is higher in children with epilepsy. Objective : Knowing the prevalence of sleep disorder in children with epilepsy, and to assess the risk factors which affecting it. Methods : A cross-sectional study was conducted at children polyclinic Cipto Mangunkusumo Hospital in Jakarta with populations of epilepsy children aged 418 years old. The assessment of sleep disorder using the sleep disturbance scale for children (SDSC), which consist of 26 questions that had been previously validated. The questionnaire will be filled out by parents regarding the child’s sleep pattern in the past 6 months. Patients who had primary sleep disorders such as obstructive sleep apnea (OSA), epilepsy syndrome, intellectual disabilities, attention deficit hyperactivity disorder (ADHD) will be excluded. Results : There were 99 subjects, with characteristics are 22.2% had intractable epilepsy, 28.2% had cerebral palsy and 64.6% generalized seizures. The prevalence of sleep disorder in child with epilepsy in this study was 71.7%, the most frequent type was disorder of starting and maintaining sleep. Risk factors that have been shown to independently affecting the incidence of sleep disorder in epilepsy patients are generalized seizures, cerebral palsy, intractable epilepsy, electroencephalography (EEG) abnormality, and non-benzodiazepine type antiepileptic drugs (AED). Conclusion : Generalized seizure, cerebral palsy, intractable epilepsy, EEG abnormality, and non-benzodiazepine type of AED are statistically significant affecting the incidence of sleep disturbance in epilepsy independently.
Keywords : sleep disorder, epilepsy, risk factor, children, sleep disturbance scale for children (SDSC)