This study primarily investigates the clinical efficacy and safety of brivaracetam in treating children with epilepsy combined with sleep disorders. A total of 84 pediatric patients meeting the inclusion criteria from June 2023 to June 2025 were selected as the study subjects and randomly divided into an observation group and a control group, with 42 cases in each group. The control group received conventional levetiracetam treatment, while the observation group was administered brivaracetam along with a standardized sleep hygiene guidance program. Both groups underwent systematic intervention for six months. By comparing data such as total effective rates, changes in the Children’s Sleep Habits Questionnaire (CSHQ) scores, polysomnography indicators, electroencephalogram (EEG) characteristics, and adverse reaction frequencies, the study verified significant differences in efficacy, EEG changes, and sleep conditions between the observation and control groups. The results showed that the observation group had a total effective rate of 90.5% and an EEG improvement rate of 83.3%, significantly higher than the control group’s 71.4% and 61.9%, respectively. Additionally, the observation group’s CSHQ scores, total sleep duration, sleep efficiency, nocturnal awakenings, and latency were all superior to those of the control group, with an adverse reaction incidence of 11.9%, markedly lower than the control group’s 31.0%. This study confirms that brivaracetam effectively controls epileptic seizures and significantly improves sleep quality in children, demonstrating good safety and practicality.