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Assessment of sleep problems in patients with Kawasaki disease: a survey-based study
Samar Tharwat1,2,3, Mohammed Kamal Nassar4
1Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt. samartharwat2000@mans.edu.eg.
Insights
Children with Kawasaki disease (KD) experience more sleep disturbances than healthy children. Factors like younger age, early onset, lethargy, and corticosteroid use are linked to poorer sleep quality in KD patients.
Area of Science:
- Pediatrics
- Sleep Medicine
- Rheumatology
Background:
- Kawasaki disease (KD) is a rare systemic inflammatory condition affecting young children.
- It is a leading cause of acquired heart disease in children in developed nations.
- Understanding KD's impact on sleep is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the prevalence and nature of sleep disturbances in children diagnosed with Kawasaki disease.
- To identify specific factors associated with sleep problems in KD patients.
Main Methods:
- A cross-sectional study involving 130 KD patients and 132 healthy controls.
- Participants completed the Children's Sleep Habits Questionnaire (CSHQ).
- Sociodemographic, clinical, and therapeutic data were collected for KD patients.
Main Results:
- KD patients reported significantly higher overall sleep disturbance scores compared to controls.
- Elevated scores were noted in sleep onset delay, night wakings, parasomnias, and sleep-disordered breathing.
- Younger age at KD onset and corticosteroid treatment were associated with poorer sleep quality.
Conclusions:
- Children with Kawasaki disease exhibit significantly greater sleep disturbances than their healthy peers.
- Sleep quality in KD is negatively impacted by younger age, early disease onset, lethargy, and corticosteroid therapy.
- These findings highlight the need for sleep assessment and management in pediatric KD care.
Introduction:
Kawasaki disease (KD) is a rare systemic inflammatory disease that primarily affects children under the age of five. It is now recognized as the most prevalent cause of acquired heart diseases in children in developed countries.
Objectives:
The aim of this study was to evaluate sleep disturbances in patients with KD and identify their prevalence and associations.
Methods:
This cross-sectional analytic survey-based study was carried out on 262 participants (130 KD patients and 132 age- and sex-matched healthy controls). Participants were invited via social media groups. Sociodemographic data, clinical characteristics and therapeutic data of KD patients were collected. To identify the presence of sleep disturbances, all participants completed Children's Sleep Habits Questionnaire (CSHQ).
Results:
The median age for KD patients was 6 years, and 51.5% of them were female, the median age at disease onset was 2.5 years, and the median disease duration was 3 years. The sleep scores of patients with KD were significantly higher than those of the control group (55.72 ± 11.97 vs. 49.45 ± 8.54, p < 0.001). The total duration of sleep did not exhibit any statistically significant difference between patients with KD and healthy controls (p = 0.399). KD patients exhibited significantly elevated scores in sleep onset delay, sleep duration, night wakings, parasomnias, and sleep-disordered breathing (p < 0.001). Additionally, they showed marginally higher scores in daytime sleepiness (p = 0.059). Younger age of KD patients was associated with higher rates of bedtime resistance (p < 0.001) and sleep anxiety (p = 0.005). Younger age at KD onset was associated significantly with higher rates of bedtime resistance (p = 0.009), sleep anxiety (p = 0.038), night wakings (p = 0.017), and worse sleep quality (p = 0.033). KD Patients who exhibited lethargy, and received corticosteroid medication had significantly higher sleep scores than those who did not.
Conclusion:
Patients with KD experience higher sleep disturbance than their healthy counterparts. Young age, early disease onset, lethargy and corticosteroid administration are linked to poor sleep quality.
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