Prevalence of sleep problems and sleep-related characteristics in preschool- and school-aged children with cerebral palsy

Abstract

ObjectivesTo determine, in preschool- and school-aged children with cerebral palsy (CP): (i) the prevalence of sleep disorders, including disorders of initiation and maintenance of sleep, and (ii) the association between child characteristics and sleep disorders. MethodsChildren with CP aged 3–12 years were recruited from neurology clinics and a provincial CP registry. Caregivers completed the Sleep Disturbance Scale for Children (SDSC) and a questionnaire on sleep-related characteristics. Children's medical information was collected from the registry and hospital records. Results150 children with CP (mean age ± standard deviation: 6.9 ± 2.9 years) completed the study (66 preschool-and 84 school-aged children). An abnormal total score on the SDSC was found in 20.7% of children (10.6% and 28.6% of preschool-and school-aged children, respectively). Overall, 44.0% of children had one or more sleep disorder (24.2% and 59.5% in preschool-and school-aged children, respectively), as determined by subscales of the SDSC. The most common sleep problem, disorders of initiation and maintenance of sleep, was found in 26.0% of children (18.2% of preschool- and 32.1% of school-aged children, respectively). Pain was the strongest predictor of having an abnormal total score and disorders of initiation and maintenance of sleep, with odds ratios (95% confidence intervals) of 6.5 (2.2–18.9) and 3.4 (1.3–9.3), respectively, adjusted for age group and degree of motor impairment. ConclusionsSleep disorders are prevalent in children with CP, with higher frequencies in school-aged as compared to preschool-aged children. Health care professionals caring for this population should routinely inquire about sleep problems and pain.