Abstract
Cerebral palsy (CP) represents the most common motor impairment in childhood. The presence of sleep problems has not yet been investigated with an instrument specifically designed for this population. In this hospital-based, prospective study, N = 100 children (M = 7.9, range: 2–18 years) with CP were included. All patients underwent pediatric neurologists’ screening incorporating instruments (Data Collection Form; Gross Motor Functions Classification System, GMFCS; Bimanual Fine Motor Function, BFMF) recommended by the “Surveillance of Cerebral Palsy in Europe (SCPE)”. Parents completed the “Sleep Questionnaire for Children with Severe Psychomotor Impairment (SNAKE)”. Children’s sleep behavior was increasingly conspicuous, with greater gross motor (SNAKE scales: disturbances remaining asleep, daytime sleepiness) and fine motor (additionally SNAKE scale arousal and breathing problems) functional impairment. Overall, a proportion of children showed sleep behavior outside the SNAKE’s normal range. No relevant sleep differences were identified between different CP subtypes and comorbidities. Applying a population-specific questionnaire, children’s functional impairment seems to be more relevant to their sleep behavior than the CP subtype or CP comorbidities.
Highlights
Cerebral palsy (CP) constitutes the most common cause of motor abnormalities in infants and children, describing a group of complex permanent motor and posture disorders that result from lesions, abnormalities, or non-progressive interferences of the developing fetal or immature brain [1,2,3].Based on children’s neurological signs and the classification of the “Surveillance of Cerebral Palsy in Europe” (SCPE) [1], different subtypes, such as spastic, dyskinetic, dystonic, ataxic, or mixed forms, can be differentiated [1,2]
Similar to already existing evidence, we identified an association between Gross Motor Function Classification System (GMFCS)/BFMF and different CP comorbidities, which again illustrates the complex interplay between functional abilities and the concomitant symptoms of the CP disease
One of the study’s main findings was that apparently not the CP disorder per se or the corresponding CP subtype is crucial for sleep or potential sleep problems in this particular population but much more the child’s functional impairment as measured by the GMFCS or BFMF
Summary
Cerebral palsy (CP) constitutes the most common cause of motor abnormalities in infants and children, describing a group of complex permanent motor and posture disorders that result from lesions, abnormalities, or non-progressive interferences of the developing fetal or immature brain [1,2,3].Based on children’s neurological signs and the classification of the “Surveillance of Cerebral Palsy in Europe” (SCPE) [1], different subtypes, such as spastic, dyskinetic, dystonic, ataxic, or mixed forms, can be differentiated [1,2]. Cerebral palsy (CP) constitutes the most common cause of motor abnormalities in infants and children, describing a group of complex permanent motor and posture disorders that result from lesions, abnormalities, or non-progressive interferences of the developing fetal or immature brain [1,2,3]. Children’s fine motor skills, on the other hand, can be defined with the help of the likewise five-level. With a prevalence of around 19–63% [1,7,8,9,10,11,12,13,14,15,16], sleep problems constitute a common phenomenon in this population, possibly triggered by the aforementioned CP comorbidities
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