Sleep and Children with Cerebral Palsy: A Review of Current Evidence and Environmental Non-Pharmacological Interventions

Abstract

Between 23%–46% of children with cerebral palsy experience sleep problems. Many of the sensory-motor and cognitive features of cerebral palsy (such as immobility, pain, and seizures) act as predisposing factors for sleep problems in this population. This paper presents the background related to the etiology and consequences of sleep problems in children with cerebral palsy. The relationship between pain and sleep is emphasized, as the risk of pain is highly prevalent in children with cerebral palsy. The review concludes with a discussion of the evidence-base for environmental non-pharmacological interventions based on light, temperature, sound and bedding to promote sleep for children with cerebral palsy.

Pain and sleep disturbances in Rett syndrome and other neurodevelopmental disorders

“…Reports have suggested that patients with autism spectrum are hyposensitive to different pain stimuli while patients with cerebral palsy, experience pain more frequently from musculoskeletal, neurological and gastrointestinal sites . Sleep problems are estimated in 18–37% of children with neurodevelopmental disorders such as Rett syndrome, autism and cerebral palsy . A complex bidirectional pain‐sleep relationship has emerged and poorer sleep might exacerbate pain by lowering pain thresholds .…”

“…Sleep problems are estimated in 18–37% of children with neurodevelopmental disorders such as Rett syndrome, autism and cerebral palsy . A complex bidirectional pain‐sleep relationship has emerged and poorer sleep might exacerbate pain by lowering pain thresholds .…”

Psychometric properties of parent and child reported sleep assessment tools in children with cerebral palsy: a systematic review

“…6,7 The severity of sleep disorders relates to the functional severity (i.e. 4,8 Sleep deficiency in children with CP has also been reported to cause sleep deprivation in their caregivers and families, which has resulted in medical health issues such as maternal depression, as well as social and professional life disruption. Children with reduced ability to roll in bed and change position may experience more waking, more pain, and be less able to respond to airway obstruction.…”

“…Gross Motor Function Classification System [GMFCS] level V). 8,9 There is no single measure that can objectively diagnose all sleep disorders. 6,7 Pain is one of the most common problems in children with CP.…”

“…Three in four children with CP have been reported to experience some degree of pain, which is multifactorial and closely linked to the prevalence of sleep problems. 4,8 Sleep deficiency in children with CP has also been reported to cause sleep deprivation in their caregivers and families, which has resulted in medical health issues such as maternal depression, as well as social and professional life disruption. 8,9 There is no single measure that can objectively diagnose all sleep disorders.…”