Investigating the Association between Sleep Problems and Physical Activity in Children with Cerebral Palsy: A Cross-Sectional Study

Given the significance of sleep and physical activity (PA) as modifiable factors influencing overall health and development in childhood, this study aims to examine the association between sleep problems and PA levels in children with cerebral palsy (CP) and to compare these findings with typically developing (TD) children.

This cross-sectional observational study included 40 children aged 6-12 years. The participant group comprised 20 children diagnosed with CP, exhibiting Gross Motor Function Classification System (GMFCS) levels I-II, and 20 age- and sex-matched TD peers. PA was measured using MOX accelerometers worn continuously for 24 hours on weekdays. Sleep habits were assessed using the Children's Sleep Habits Questionnaire (CSHQ) and the Epworth Sleepiness Scale (ESS), both completed by parents.

Children with CP demonstrated significantly lower levels of light, moderate, and vigorous PA compared to children with TD (p < 0.05). No significant difference was observed in total sleep habit scores between the groups (p = 0.423). A significant positive correlation was found between moderate PA and sleep habit in the CP group (r = 0.49, p = 0.03). Among children with TD, those with sleep problems engaged in significantly less vigorous PA than those without (p = 0.044).

Children with CP exhibit lower PA levels than their TD peers. In this population, moderate-intensity PA appears to have a positive effect on sleep problems. Promoting moderate PA may contribute to improved sleep and overall health in children with CP. These findings highlight the importance of integrated PA and sleep health strategies in pediatric rehabilitation.