Sleep Assessments for Children With Severe Cerebral Palsy: A Scoping Review

Abstract

Objectives To identify the sleep-based instruments in postural care intervention research and examine whether the instruments are suitable as postural care outcome measures specifically for children with severe cerebral palsy. Data Sources Investigators searched the electronic databases from 2 university library systems, including OVID Medline, CINAHL, OT Search, Cochrane Database of Systematic Reviews, and Health and Psychosocial Instruments for articles published between 2000 and October 2019. Study Selection The initial search yielded 1928 abstracts. Two independent investigators identified 8 English-language peer-reviewed articles that published postural care intervention study results. Data Extraction Investigators screened the 8 articles and found that 6 included sleep as a primary or secondary intervention outcome. The principal investigator then fully reviewed these 6 publications, recorded their sleep-related instruments, and applied Coster’s published guidelines (2013) to analyze the sleep-based instruments' suitability as outcome measures. Data Synthesis: Collectively, the 6 studies used 8 distinct measures, 6 of which (actigraphy, Chailey Sleep Questionnaire, Pediatric Sleep Questionnaire, polysomnography, sleep diary, and Sleep Disturbance Scale for Children) underwent analysis. As stand-alone instruments, none completely met criteria for suitability as outcome measures for those with severe cerebral palsy. Conclusions Combined use of the Sleep Disturbance Scale for Children and actigraphy may be favorable for assessing the sleep-related domains relevant to children with severe cerebral palsy. However, rehabilitation professionals should test sensitivity and specificity to understand the instruments’ ability for capturing changes in sleep from postural care intervention.

Concordance between subjective and objective measures of infant sleep varies by age and maternal mood: Implications for studies of sleep and cognitive development

“…In homogenous samples and narrow age groups this is likely less of an issue, as sleeps varies less ( Bathory and Tomopoulos, 2017 , Gorgoni et al, 2019 ). Lastly, for populations with unusual movement patterns (e.g., cerebral palsy) or infants who mainly sleep in buggies or car seats, actigraphy might be less reflective of true, underlying sleep ( Meltzer et al, 2012 , Galland et al, 2018 , Hutson and Snow, 2020 ).…”

Assessment of Sleep-Related Problems in Children with Cerebral Palsy Using the SNAKE Sleep Questionnaire

“…In contrast to other questionnaires currently in use, it is conceivable that the SNAKE is capable of appropriately contextualizing the sleep behavior of children with underlying CP disorders and does not “false positively” declare it a disorder. This strongly suggests that for special populations, particular instruments should always be used [ 15 , 52 ]. We identified an association between the children’s global sleep quality and the presence of a hearing impairment.…”

Sleep Disorder Prevalence and Influencing Factors in Children with Cerebral Palsy

“…1,2 Children with neurological developmental disorders such as cerebral palsy are included in the population with a high risk for sleep disorders. 2,3 Cerebral palsy is a group of movement and posture disorders that cause limited movement due to non-progressive disorders in the brains of developing fetuses or infants. In developing countries, including Indonesia, cerebral palsy is estimated to occur in 1.5-2.5 children per 1,000 live births and is the most common cause of physical abnormalities in children.…”