An observational study of sleep in childhood post-neonatal encephalopathy.

Abstract

Neonatal encephalopathy (NE) is associated with altered cognitive, motor, sensory abilities and behavioural outcomes. This case-control study aimed to assess whether Quality of Life (QoL) and sleep disorders are affected in older children following NE compared to age-matched controls. Children at school-age post-NE were recruited and compared to age-matched controls. Sleep and QoL were assessed with the Pediatric Quality of Life Inventory and the Child Sleep Habit Questionnaire. One hundred children were recruited with an age range of 4-6years, including children post-NE (n=45) and age-matched controls (n=55). Significantly higher pathological sleep scores were evident in 58% of children post-NE compared to controls (43.8 vs 40.2; p=0.001). Children post-NE had increased bedtime resistance (p=0.028) and sleep anxiety (p=0.01) compared to controls. Children in the post-NE group had lower total QoL scores versus controls (mean score 82.5 vs 95.8; p<0.01). Children with mild NE also had lower total QoL scores than controls (90.0 vs 95.8, p=0.003). There was a strong correlation between low QoL with high total sleep scores (Rho 0.339, p=0.014). There were high rates of sleep issues in school-aged children with mild and moderate-severe NE. Consideration and management of sleep problems may improve QoL in childhood post-NE.