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Sleep problems and sleep disordered breathing in children with cerebral palsy

R Dhandayuthapani1, C M McDougall2, F Gahleitner3

  • 1Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, United Kingdom; Department of Child Life and Health, University of Edinburgh, United Kingdom; Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.

Paediatric Respiratory Reviews
|May 4, 2025
PubMed

Insights

Children with cerebral palsy (CP) often experience sleep disorders, including sleep-disordered breathing (SDB). Diagnosis involves sleep studies, and management may include respiratory support like CPAP or NIV to improve quality of life.

Area of Science:

  • Neurology
  • Pediatrics
  • Sleep Medicine

Background:

  • Cerebral palsy (CP) affects movement and posture due to brain injury, often accompanied by comorbidities like sleep disorders.
  • Sleep disorders, particularly sleep-disordered breathing (SDB), are more common in children and young people (CYP) with CP than in typically developing peers.
  • SDB encompasses obstructive sleep apnoea (OSA), central sleep apnoea (CSA), and hypoventilation, influenced by various intrinsic and extrinsic factors.

Purpose of the Study:

  • To investigate the prevalence and contributing factors of sleep-disordered breathing (SDB) in children and young people (CYP) with cerebral palsy (CP).
  • To outline diagnostic methods for SDB in CYP with CP.
  • To discuss management strategies and the role of respiratory support in improving quality of life for CYP with CP.

Main Methods:

  • Utilized sleep studies, including polysomnography and cardiorespiratory polygraphy, to detect SDB.
  • Measured oxygen saturation (SpO2) and transcutaneous carbon dioxide (tcpCO2) during sleep studies.
  • Reviewed conservative measures, surgical options, and respiratory support (CPAP, NIV) for SDB management.

Main Results:

  • Sleep studies enable diagnosis and classification of SDB (OSA, CSA, hypoventilation) by monitoring respiratory effort, apnoea, SpO2, and tcpCO2.
  • Interventions for SDB in CYP with CP range from conservative (airways, collars) to surgical (adenotonsillectomy) and respiratory support.
  • Respiratory support (CPAP/NIV) is increasingly used, not only for SDB but also for airway clearance, despite potential management challenges.

Conclusions:

  • SDB is a significant comorbidity in CYP with CP, requiring accurate diagnosis through sleep studies.
  • Management of SDB in CYP with CP is multifactorial, involving various interventions including respiratory support.
  • Effective management, including open communication and shared goal-setting, is crucial for improving the quality of life for CYP with CP.

Keywords:
Central sleep apnoeaCerebral palsyContinuous Positive Airway PressureHypoventilationNon-invasive ventilationObstructive sleep apnoea

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