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Sleep disturbances and behavioural and emotional problems in preschool children with bilateral cerebral palsy

Schlaf‑, Verhaltens- und emotionale Störungen bei Vorschulkindern mit bilateraler Zerebralparese

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Abstract

Background

Sleep disturbances are likely to be associated with emotional and behavioural problems.

Objective

This study evaluated sleep disturbances in preschool children with bilateral cerebral palsy (CP) and assessed their associations with behavioural and emotional problems.

Patients and methods

The study was performed in St. Petersburg in 2016, and comprised 20 children with diagnosed bilateral CP aged 5 years (10 boys, 10 girls) who attended a special educational centre. The control group was made up of 80 clinically healthy, typically developing children, who were matched as closely as possible to the cases in terms of age, gender and geographical distribution. Mothers were requested to fill in the Child Sleep Habit Questionnaire (CSHQ) aimed at measuring certain sleep problems in children. Teachers were approached with the Achenbach Caregiver-Teacher Report Form for ages 1.5–5 years (C-TRF) aimed at finding major emotional and behavioural disturbances.

Results

Children with CP had significantly higher scores (more problems) on reported sleep onset delay, sleep duration and daytime sleepiness. They also scored higher on all Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented behaviour problem scales. Both the diagnosis of CP and sleep disturbances were significant predictors of certain behavioural deviations, including anxiety, pervasive developmental and oppositional defiant problems. Based on the data mining procedure, an explanatory model that brought together the found associations was constructed.

Conclusion

Sleep disturbances in children with CP may be associated with behavioural problems.

Zusammenfassung

Hintergrund

Schlafstörungen sind wahrscheinlich mit emotionalen und Verhaltensstörungen verbunden.

Ziel der Arbeit

In der vorliegenden Studie wurden Schlafstörungen bei Vorschulkindern mit bilateraler Zerebralparese (CP) untersucht und ihr Zusammenhang mit Verhaltens- und emotionalen Störungen ermittelt.

Patienten und Methoden

Die Studie wurde 2016 in St. Petersburg durchgeführt und umfasste 20 Kinder im Alter von 5 Jahren mit bilateraler CP (10 m., 10 w.), die eine sonderpädagogische Einrichtung besuchten. Die Kontrollgruppe bestand aus 80 klinisch gesunden Kindern mit normaler Entwicklung, die möglichst genau wie die Fälle in Bezug auf Alter, Geschlecht und geographische Verteilung ausgesucht wurden. Die Mütter wurden gebeten, den Child Sleep Habit Questionnaire (CSHQ) auszufüllen, einen Fragebogen zur Messung bestimmter Schlafstörungen bei Kindern. Den Lehrern wurde der Fragebogen Achenbach Caregiver-Teacher Report Form für das Alter 1,5–5 Jahre (C-TRF) vorgelegt, der zur Erfassung von schweren emotionalen und Verhaltensstörungen dient.

Ergebnisse

Kinder mit CP wiesen signifikant höhere Punktwerte (mehr Probleme) bei der angegebenen Verzögerung des Schlafbeginns, Schlafdauer und Tagesschläfrigkeit auf. Sie hatten auch höhere Werte in allen am Diagnostic and Statistical Manual of Mental Disorders (DSM) orientierten verhaltensbezogenen Problemskalen. Sowohl die Diagnose einer CP als auch Schlafstörungen waren signifikante Prädiktoren bestimmter Verhaltensauffälligkeiten, einschließlich Angst, tiefgreifender Entwicklungsstörung und oppositionellem Verweigerungsverhalten. Auf der Grundlage des Datengewinnungsverfahrens wurde ein Erklärungsmodell konstruiert, das die ermittelten Zuordnungen zusammenbrachte.

Schlussfolgerung

Schlafstörungen bei Kindern mit CP sind möglicherweise mit Verhaltensstörungen verknüpft.

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Acknowledgements

The author would like to thank the undergraduate students of the Institute of Special Education and Special Psychology of the Raoul Wallenberg International University for Family and Child for their help in collecting raw data.

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Authors and Affiliations

  1. Institute of Special Education and Special Psychology of the Raoul Wallenberg International University for Family and Child, 92 Bolshaya Ozernaya Str., 194356, St. Petersburg, Russian Federation

    Igor A. Kelmanson

  2. St. Petersburg State Institute of Psychology and Social Work, 13-A Vasilyevsky Ostrov 12th Line, 199178, St. Petersburg, Russian Federation

    Igor A. Kelmanson

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Correspondence to Igor A. Kelmanson.

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I.A. Kelmanson declares that he has no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Kelmanson, I.A. Sleep disturbances and behavioural and emotional problems in preschool children with bilateral cerebral palsy. Somnologie 22, 18–26 (2018). https://doi.org/10.1007/s11818-017-0121-9

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