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Sleep Problems in Children With Developmental Delays and Neurodevelopmental Comorbidities: A Retrospective
Kin Lok Wong1, Shuk Kuen Chau2, So Lun Lee2
1Paediatrics, Queen Elizabeth Hospital, Kowloon, HKG.
Insights
Children with developmental delay (DD) experience significant sleep problems, especially those with neurological or psychobehavioral comorbidities. These comorbidities impact sleep resistance and daily life more than isolated DD.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Sleep Medicine
Background:
- Sleep disturbances are more prevalent in children with developmental delay (DD).
- Limited research exists on the specific impact of comorbidities on sleep in children with DD.
Purpose of the Study:
- To compare sleep patterns and disturbances in children with DD and comorbidities versus those with isolated DD.
- To investigate differences between neurological and psychobehavioral comorbidities regarding sleep issues.
Main Methods:
- Retrospective, single-center study of 529 children attending a neurodevelopmental clinic.
- Utilized parent-rated questionnaires to assess sleep patterns and disturbances.
- Categorized subjects into isolated DD, DD with neurological comorbidities, and DD with psychobehavioral comorbidities.
Main Results:
- Sleep schedules showed minimal differences across all groups.
- Over half of the children experienced insufficient sleep hours.
- Children with neurological comorbidities had higher sleep resistance; those with psychobehavioral comorbidities had higher sleep resistance and lower sleep parasomnia scores.
- Parental satisfaction with sleep quality was lower in the neurological comorbidity group.
- Parents of children with psychobehavioral comorbidities reported a greater daily life impact from sleep problems.
Conclusions:
- Sleep schedules are similar across isolated DD and DD with comorbidities.
- All groups exhibit a high prevalence of sleep problems.
- Regular sleep problem screening is crucial, especially for children with DD and comorbid neurological or psychobehavioral conditions.
Abstract:
Background Sleep disturbances are more common in children with developmental delay (DD) than in typically developing children. There is limited research on whether sleep impact is more pronounced in children with DD and comorbidities. Objective Our study compared sleep patterns and disturbances in children with DD and neurological or psychobehavioral comorbidities to those with isolated DD. Methodology We conducted a single-center retrospective study utilizing a parent-rated questionnaire on neurodevelopmental clinic attendees over six months. Subjects were categorized into three groups: (1) isolated DD; (2) DD with comorbid neurological conditions; and (3) DD with comorbid psychobehavioral conditions. Results A total of 529 subjects were included. The results revealed minimal differences in sleep schedules between the groups. More than half of the sample (276, 52.2%) had insufficient sleep hours, with no significant variation across groups. A substantial proportion of the sample took regular naps, with 340 (79.3%) on weekdays and 279 (69.9%) on weekends. Compared to the isolated DD group, the comorbid neurological group showed a higher sleep resistance score, while comorbid psychobehavioral conditions were associated with higher sleep resistance scores and lower sleep parasomnia scores. A lower portion of the comorbid neurological group had their parents satisfied with their sleep quality (16, 32.7%, vs. 121, 52.2%). A higher percentage of parents in the comorbid psychobehavioral group reported significant daily life impact due to their children's sleep problems (65, 28.0%, vs. 41, 17.1%). Conclusions The sleep schedule in all three groups closely resembled each other. All three groups exhibited a high prevalence of sleep-related problems. Regular screening for sleep problems is recommended, particularly for children with DD and neurological or psychobehavioral comorbidities.
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