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Prevalence and factors associated with sleep disorders among children with cerebral palsy in Uganda; a

Kisughu Munyumu¹, Richard Idro², Catherine Abbo³

¹Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda. kisughumunyumu@gmail.com.

|February 7, 2018

Insights

Sleep disorders are common in children with cerebral palsy (CP) in Uganda, affecting 32% of those studied. Severe disability and epilepsy were linked to these sleep problems, highlighting the need for targeted interventions.

Area of Science:

Pediatric Neurology
Sleep Medicine
Developmental Pediatrics

Background:

Sleep disorders (SDs) are more prevalent in children with cerebral palsy (CP) compared to their peers.
These SDs encompass issues with sleep initiation, maintenance, transition, excessive sleepiness, and arousal, significantly impacting quality of life.
There is limited data on sleep disorders, particularly sleep breathing disorder (SBD), among children with CP in Uganda.

Purpose of the Study:

To determine the prevalence of sleep disorders among children aged 2-12 years with CP in Uganda.
To identify factors associated with sleep disorders in this population.
To inform the development of targeted interventions to improve the quality of life for children with CP.

Main Methods:

A cross-sectional study was conducted.
Participants underwent a physical examination and screening using the Sleep Disturbances Scale for Children (SDSC) questionnaire.
A total score (TS) ≥ 51 on the SDSC was considered indicative of abnormal sleep patterns.

Main Results:

The study included 135 children with CP.
A prevalence of 32% (43/135) for sleep disorders was found, with disorders of initiating and maintaining sleep being the most common (27%).
Associated factors included bilateral spasticity, severe gross motor dysfunction (GMFCS V/IV), severe manual ability impairment (BM I V), and the presence of epilepsy.

Conclusions:

Sleep disorders are highly prevalent in children with cerebral palsy in Uganda.
Severe disability, specifically in gross motor and manual abilities, and the presence of epilepsy are significantly associated with sleep disorders in this cohort.
Findings underscore the need for comprehensive sleep assessments and interventions for children with CP, particularly those with co-occurring epilepsy and severe functional impairments.

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Abstract

Background:

Sleep plays a prominent role in the growth and development of children. Children with cerebral palsy (CP) are more prone to sleep disorders (SDs) than their peers. Children with CP, have a higher prevalence of disorders involving; initiation and maintenance of sleep, sleep-wake transition, excessive sleepiness and arousal. These sleep disorders impact on the quality of life of these children. Despite, having a high prevalence of CP in Uganda, there is a paucity of data that focuses on sleep disorders in CP, including a lack of prevalence estimates of sleep breathing disorder (SBD) in CP. Understanding the prevalence and disorders of sleep within this population would help advise on the development of tailored interventions to address the needs of these children and improve their quality of life. This study determined the prevalence and associated factors of sleep disorders among children aged 2 - 12 years with cerebral palsy in Uganda.

Methods:

This was a cross sectional study. All participants had a physical examination and screening with the Sleep Disturbances Scale for Children (SDSC) questionnaire to determine the prevalence of sleeps disorders. A total score (TS) ≥ 51 on the Sleep Disturbances Scale for Children was regarded as abnormal.

Results:

A total of 135 participants were recruited. The prevalence of sleep disorders was 43/135 (32%) with 95% CI: (24.0-39.7). The most common type of sleep disorders was a disorder of initiating and maintaining sleep 37(27%). The factors associated with sleep disorders among children with cerebral palsy were bilateral spasticity (p = 0.004); OR:(95%CI), 11.193: (2.1 - 59.0), lowest levels of gross motor function V (p = < 0.001); OR:(95%CI), 13.182: (3.7 - 47.0) or IV (p = 0.007); OR:(95%CI), 12.921: (2.0 - 82.3), lowest level of manual ability V (p = 0.004); OR:(95%CI), 11.162: (2.2 - 56.4) and presence of epilepsy (p = 0.011); OR:(95%CI), 3.865: (1.4 - 10.9).

Conclusions:

The prevalence of sleep disorders among children with cerebral palsy in Uganda is high. Severe disability and presence of epilepsy were associated with sleep disorders among children with cerebral palsy.

Keywords:

Sleep Disturbance Scale for Children (SDSC)Uganda cerebral palsy children sleep disorders

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