Prevalence of Sleep Disorders in Children with Cerebral Palsy; A Questionnaire-based Observational Study
Shilpa Kulkarni1, Tanmay Sanjay Jadhav1
1Department of Paediatric Neurosciences, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra, India.
Insights
Sleep disturbances are common in children with cerebral palsy (CP), with 62% experiencing pathological sleep. Disorders of Initiation and Maintenance of Sleep (DIMS) are the most frequent type, impacting quality of life.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Sleep Medicine
Background:
- Cerebral palsy (CP) is a common developmental disorder with significant comorbidities.
- Sleep disturbances are frequently reported by parents of children with CP but often overlooked.
- These sleep issues can substantially impact the quality of life for both children and their families.
Purpose of the Study:
- To determine the prevalence and specific patterns of sleep disorders (SD) in children with CP.
- To identify the types of sleep disturbances most commonly affecting this population.
- To explore the relationship between motor function and sleep problems in children with CP.
Main Methods:
- A questionnaire-based observational study was conducted over six months at a pediatric tertiary care center.
- 200 children aged 1-14 years with CP were enrolled using convenience sampling.
- The Sleep Disturbance Scale for Children (SDSC) was used to assess sleep pathology and categorize disorders.
Main Results:
- 62% of children (124 out of 200) exhibited pathological sleep scores (score >39).
- Disorders of Initiation and Maintenance of Sleep (DIMS) were the most prevalent, affecting 78.2% of those with abnormal sleep scores.
- Children with quadriplegia and those in GMFCS V demonstrated the most severe sleep disturbances.
Conclusions:
- Sleep disturbances are under-recognized in children with CP.
- DIMS is the most common sleep disorder in this population.
- A direct correlation exists between the severity of motor impairment and the extent of sleep disturbances in children with CP.
Background:
Cerebral palsy (CP), the most common developmental disorder, has many comorbidities (epilepsy and behavioral issues). Sleep disturbances are common complaints of parents and are usually neglected in pediatric populations in comparison to other well-documented co-morbidities of CP but may have a significant effect on the quality of life of children and their parents.
Objective:
To study the prevalence and pattern of sleep disorders (SD) in children with CP.
Study Design:
Questionnaire-based observational study.
Setting:
Pediatric tertiary care center. The study was done over 6 months.
Participants:
In total, 200 children with CP between the ages of 1 year to 14 years were included in the study by convenience sampling. Co-morbid health problems involving cardiorespiratory system, other illness (e.g. epilepsy and gastroesophageal reflux disease), or children on anticonvulsant medications altering sleep patterns were excluded.
Intervention:
The Sleep Disturbance Scale for Children (SDSC) was administered to assess the presence of pathological sleep and type of SD ranging between Disorders of Initiation and Maintenance of Sleep (DIMS), Sleep Breathing disorders (SBD), Disorders of Arousal (DA), Sleep-Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DES), and Sleep Hyperhydrosis (SHY).
Main Outcome Measures:
Sixty-two percentage of children (124) had a pathological total sleep score (score >39).
Results:
DIMS are the most common, occurring in 78.2% of subjects with a pathological sleep score (score >39). Quadriplegics [n = 96, mean score = 49.86(16.38)] and GMFCS V [n = 19, mean score = 58.00(17.10)] are most severely affected.
Conclusion And Discussion:
Children with CP have under-reported SD and DIMS is the most common type of SD. There is a linear correlation between the extent of topographical and motor afflictions and SD.
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