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Self-reported quantity and quality of sleep in children and adolescents with a chronic condition compared to healthy
Camille F M Biemans1, Sanne L Nijhof2, Jan Willem Gorter3,4
1Center of Excellence for Rehabilitation Medicine, University Medical Center (UMC) Utrecht Brain Center, UMC Utrecht, Utrecht University (UU) and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. c.f.m.biemans@umcutrecht.nl.
Insights
Children with chronic conditions generally meet recommended sleep hours but many report poor sleep quality, especially those with medically unexplained symptoms (MUS). Further research is needed to understand these sleep quality issues.
Area of Science:
- Pediatric Sleep Medicine
- Child Health Research
- Chronic Illness in Children
Background:
- Recommended sleep duration for children and adolescents varies by age.
- Limited research exists on sleep quantity and quality in pediatric chronic conditions.
- Self-reported sleep is crucial for assessing well-being in youth.
Purpose of the Study:
- To evaluate self-reported sleep quantity and quality in Dutch children with chronic conditions.
- To compare sleep patterns of these children against healthy controls and recommended sleep durations.
- To investigate sleep differences among various chronic conditions, including medically unexplained symptoms (MUS).
Main Methods:
- Cross-sectional study involving 291 children (15±3.1 years) with chronic conditions (e.g., cystic fibrosis, kidney disease, heart disease, autoimmune disease, MUS).
- Propensity score matching used to create a 1:4 ratio of matched healthy controls (n=171).
- Established questionnaires assessed self-reported sleep quantity and quality.
Main Results:
- Children with chronic conditions generally met recommended sleep durations.
- 22% of children with chronic conditions reported poor sleep quality.
- Children with chronic conditions and MUS slept more than healthy controls at ages 13, 15, and 16.
- Poor sleep quality was least common in chronic conditions and most frequent in MUS.
Conclusions:
- Children with chronic conditions, including MUS, meet recommended sleep hours and sleep more than healthy peers.
- A significant proportion of children with chronic conditions, particularly MUS, experience poor sleep quality.
- Understanding the reasons behind poor sleep quality in this subset is essential for improving child health outcomes.
Abstract:
To assess self-reported quantity and quality of sleep in Dutch children with a chronic condition compared to healthy controls and to the recommended hours of sleep for youth. Sleep quantity and quality were analyzed in children with a chronic condition (cystic fibrosis, chronic kidney disease, congenital heart disease, (auto-)immune disease, and medically unexplained symptoms (MUS); n = 291; 15 ± 3.1 years, 63% female. A subset of 171 children with a chronic condition were matched to healthy controls using Propensity Score matching, based on age and sex, ratio 1:4. Self-reported sleep quantity and quality were assessed with established questionnaires. Children with MUS were analyzed separately to distinguish between chronic conditions with and without an identified pathophysiological cause. Generally, children with a chronic condition met the recommended amount of sleep, however 22% reported poor sleep quality. No significant differences in sleep quantity and quality were found between the diagnosis groups. Children with a chronic condition and with MUS slept significantly more than healthy controls at ages 13, 15, and 16. Both at primary and secondary school, poor sleep quality was least frequent reported in children with a chronic condition and most often reported in children with MUS. Conclusion: Overall, children with chronic conditions, including MUS, met the recommended hours of sleep for youth, and slept more than healthy controls. However, it is important to obtain a better understanding of why a substantial subset of children with chronic conditions, mostly children with MUS, still perceived their sleep quality as poor. What is Known: • According to the Consensus statement of the American Academy of Sleep medicine, typically developing children (6 to 12 years) should sleep 9 to 12 h per night, and adolescents (13 to 18 years) should sleep 8 to 10 h per night. • Literature on the optimal quantity and quality of sleep in children with a chronic condition is very limited. What is New: Our findings are important and provide novel insights: • In general, children with a chronic condition sleep according to the recommended hours of sleep. • A substantial subset of children with chronic conditions, perceived their sleep quality as poor. Although this was reported mostly by children with medically unexplained symptoms (MUS), the found poor sleep quality was independent of specific diagnosis.
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