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Sleep Measure Validation in a Pediatric Neurocritical Care Acquired Brain Injury Population
Katrina M Poppert Cordts1,2, Trevor A Hall2,3, Mary E Hartman4
1Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA.
Insights
The Sleep Disturbance Scale for Children (SDSC) effectively measures sleep problems in youth after pediatric neurocritical care (PNCC). Validating the SDSC aids in addressing Post-Intensive Care Syndrome and improving recovery.
Area of Science:
- Pediatric critical care medicine
- Neurocritical care
- Sleep medicine
Background:
- Post-Intensive Care Syndrome (PICS) involves physical, cognitive, emotional, and psychosocial issues persisting after pediatric neurocritical care (PNCC).
- Sleep disturbances are a common PICS sequela, impacting recovery but are under-evaluated due to a lack of validated measurement tools.
- Assessing sleep problems is crucial for understanding and managing PICS in pediatric neurocritical care survivors.
Purpose of the Study:
- To evaluate the validity and reliability of the Sleep Disturbance Scale for Children (SDSC) for assessing sleep problems in youth following PNCC.
- To establish the SDSC as a reliable tool for identifying sleep disturbances in children with acquired brain injuries post-PNCC.
Main Methods:
- A prospective observational study involving 69 youth (aged 3-17 years) with acquired brain injury admitted to PNCC programs.
- Parents completed the SDSC and provided proxy reports on internalizing symptoms, HRQOL, fatigue, pain, and cognitive function within 3 months of discharge.
- Validity was assessed by comparing SDSC scores with psychosocial measures and by analyzing outcomes based on risk severity (Low, Mild-Moderate, High Risk).
Main Results:
- The SDSC demonstrated good internal consistency (α = .81).
- Increased SDSC scores significantly correlated with worse physical, psychological, and cognitive PICS sequelae.
- Youth in the High Risk group showed greater deficits in mental acuity, pain, internalizing symptoms, and social engagement, with significant impacts on HRQOL.
Conclusions:
- The SDSC is a valid and reliable instrument for assessing sleep disturbances in children after PNCC.
- Findings support the use of the SDSC to monitor sleep issues and guide interventions in this population.
- Targeted interventions addressing sleep disturbances are essential for optimizing overall patient recovery from PNCC.
Background/Objective:
Lingering morbidities including physical, cognitive, emotional, and psychosocial sequelae, termed the Post-Intensive Care Syndrome, persist years after pediatric neurocritical care (PNCC) hospitalization. Sleep disturbances impact other Post-Intensive Care Syndrome domains and are under-evaluated to date due to a lack of appropriate measurement tools. The present study evaluated the validity of the Sleep Disturbance Scale for Children (SDSC) to address the growing need for assessing sleep problems after PNCC.
Methods:
We conducted a prospective observational study of youth aged 3-17 years with acquired brain injury (N = 69) receiving care through longitudinal PNCC programs at two tertiary academic medical centers. Parents completed the SDSC and provided proxy reports of internalizing symptoms, health-related quality of life (HRQOL), fatigue, pain behavior, and cognitive function within 3 months of hospital discharge. Evidence for the validity of the SDSC was established by utilizing the full sample for psychosocial measure comparisons and by comparing SDSC outcomes by severity (Low Risk, Mild-Moderate Risk, and High Risk defined by reported standardized T-scores).
Results:
Internal consistency of the SDSC was good (α = .81). Within the full sample, increased sleep disturbances on the SDSC were significantly correlated with Post-Intensive Care Syndrome measures, including worse physical (r = .65), psychological (r = .62), and cognitive (r = - .74) sequelae. Youth in the High Risk group evidenced greater dysfunction in mental acuity, pain behavior, internalizing symptoms, and social engagement. Findings revealed both statistically and clinically significant impacts of sleep disturbances as measured by the SDSC on HRQOL.
Conclusions:
The SDSC is a valid and reliable measure for assessing sleep disturbances in children after PNCC. Results support the use of the SDSC to measure sleep disturbances after PNCC. Targeted interventions for sleep disturbances may be key to overall patient recovery.
