Sleep disorders in children with cerebral palsy: An integrative review

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

“…Any tool developed in the future for this population of children should take into account some important points: (1) it should be based on definitions given by the ICSD and related definitions given by ICF; (2) it should consider their differences given by age, cognition, and developmental stage as well as their type of CP and GMFCS; (3) the measure should focus on the relevant areas of sleep to be impacted, as those categorised by Galland et al, and L elis et al, which represent the common sleep problems in this population of children 6,7 ; (4) the measure should have screening and diagnostic use; (5) its primary purpose should ideally be evaluative and predictive rather than just discriminative; (6) the questionnaire should be validated based on well-designed guidelines such as the COSMIN guidelines; (7) there should be clear hypotheses being tested; (8) it should take a short time to complete and have a scoring system easy to apply; (9) the tool should be tested parallel to other objective sleep measures such as polysomnography or actigraphy. Any tool developed in the future for this population of children should take into account some important points: (1) it should be based on definitions given by the ICSD and related definitions given by ICF; (2) it should consider their differences given by age, cognition, and developmental stage as well as their type of CP and GMFCS; (3) the measure should focus on the relevant areas of sleep to be impacted, as those categorised by Galland et al, and L elis et al, which represent the common sleep problems in this population of children 6,7 ; (4) the measure should have screening and diagnostic use; (5) its primary purpose should ideally be evaluative and predictive rather than just discriminative; (6) the questionnaire should be validated based on well-designed guidelines such as the COSMIN guidelines; (7) there should be clear hypotheses being tested; (8) it should take a short time to complete and have a scoring system easy to apply; (9) the tool should be tested parallel to other objective sleep measures such as polysomnography or actigraphy.…”

“…1,5 Disorders of initiation and maintenance of sleep have been shown to be more frequent in children with spastic quadriplegia and dyskinetic CP and visual impairment, because of a delayed surge in nocturnal melatonin. 6,7 The severity of sleep disorders relates to the functional severity (i.e. 6,7 The severity of sleep disorders relates to the functional severity (i.e.…”

“…1,6 Sleep related breathing disturbances are multifactorial with glossoptosis, adenotonsilar hypertrophy, increased muscle tone, and recurrent aspiration, all important contributors. 6,7 The severity of sleep disorders relates to the functional severity (i.e. Gross Motor Function Classification System [GMFCS] level V).…”

“…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. 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.…”

Sleep disorders in cerebral palsy

“…2 Intrinsic factors include neurological factors, of which the presence of nocturnal seizures is the most important. The mechanisms are complex and probably include sleep fragmentation secondary to seizures, anticonvulsants compromising sleep and daytime alertness, and alteration in caregivers' approach to sleep associations.…”