Sleep disorders in children with cerebral palsy

Abstract

To determine the frequency and predictors of sleep disorders in children with cerebral palsy (CP) we analyzed the responses of 173 parents who had completed the Sleep Disturbance Scale for Children. The study population included 100 males (57.8%) and 73 females (42.2%; mean age 8y 10mo [SD 1y 11mo]; range 6y-11y 11mo). Eighty-three children (48.0%) had spastic diplegia, 59 (34.1%) congenital hemiplegia, 18 (10.4%) spastic quadriplegia, and 13 (7.5%) dystonic/dyskinetic CP. Seventy-three children (42.2%) were in Gross Motor Function Classification System Level I, 33 (19.1%) in Level II, 30 (17.3%) in Level III, 23 (13.3%) in Level IV, and 14 (8.1%) in Level V. Thirty children (17.3%) had epilepsy. A total sleep problem score and six factors indicative of the most common areas of sleep disorder in childhood were obtained. Of the children in our study, 23% had a pathological total sleep score, in comparison with 5% of children in the general population. Difficulty in initiating and maintaining sleep, sleep-wake transition, and sleep breathing disorders were the most frequently identified problems. Active epilepsy was associated with the presence of a sleep disorder (odds ratio [OR]=17.1, 95% confidence interval [CI] 2.5-115.3), as was being the child of a single-parent family (OR=3.9, 95% CI 1.3-11.6). Disorders of initiation and maintenance of sleep were more frequent in children with spastic quadriplegia (OR=12.9, 95% CI 1.9-88.0), those with dyskinetic CP (OR=20.6, 95% CI 3.1-135.0), and those with severe visual impairment (OR=12.5, 95% CI 2.5-63.1). Both medical and environmental factors seem to contribute to the increased frequency of chronic sleep disorders in children with CP.

Prevalence of orofacial dysfunction in cerebral palsy and its association with gross motor function and manual ability

“…7 Previous studies have reported somewhat lower prevalences than the present study for articulation problems, 11 no useful speech, 7 and snoring. 26 These differences may be because of differences in questions asked, in definitions across studies, or possible reliability deficiencies of instruments used or differences in sample compositions. The prevalence of other aspects of OFD in CP than those mentioned above can, to the best of our knowledge, only be compared with studies based on clinical samples.…”

Replacing home visits with telephone calls to support parents implementing a sleep management intervention: findings from a pilot study and implications for future research

“…As with typically developing children, the origins are often behavioural, (Wiggs 2009, Newman et al 2006, Stores and Stores 2013. Learning difficulties and communication impairments may hinder the establishment of appropriate sleep routines, and may be low, believing that sleep problems a part of .…”

Effects of Yoga on Sleep Quality, Depression in Children with Cerebral Palsy

“…Although 5% sleep disorder was seen in children who display normal growth and development, it has been shown that much higher rates of sleep problems were experienced in children with CP [32]. It is known that there are difficulties in beginning and sustaining sleep, irregular sleep and wakefulness transitions, respiratory problems related to sleep and an increased state of sleepiness in children with CP [33].…”

“…In addition, it is stated that sleep inefficiency affects children's behavioral problems as well [8]. Although about 5% sleep disorder has been observed in children who display normal growth and development, studies have shown that there is a much higher rate of sleep problem in children with CP [9]. In children with CP, insufficiency in starting and sustaining sleep, irregular sleep-wakefulness transitions, respiratory difficulties related to sleep and increased day time sleepiness have been reported [10].…”