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Sleep Disorders and Quality of Life in Children with Cerebral Palsy

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Abstract

Objectives

To determine sleep disorders and quality of life (QOL) in children with cerebral palsy (CP) and to find the association between them.

Methods

This cross-sectional study included children (4–12 y) with CP (n = 117) and age- and gender-matched healthy controls (n = 117). Pediatric Sleep Questionnaire (PSQ) was used to record sleep-related symptoms. Sleep-related breathing disorder (SRBD) scale and sleep disturbance scale for children (SDSC) were used to evaluate sleep disorders. Cerebral palsy quality-of-life questionnaire for children (CPQOL-CHILD) was used to assess QOL.

Results

Sleep disorders by SRBD scale (score ≥ 0.33) were significantly more in CP (n = 7, 6%) than controls [(n = 0, 0%) (p value 0.014, OR 15.95)]. Using T score > 70 by SDSC scale, sleep disorders were seen in 7.7% (n = 9) CP children and 0% (n = 0) in controls (p value 0.04, OR 20.6). Using T score ≥ 51, 43.6% CP children and 17% controls had sleep disorders (p value 0.001, CI 2.1, 6.9). About 43.6% CP children had abnormal T score on at least one SDSC factor. Presence of epilepsy, motor disabilities, intellectual disabilities, and type of CP significantly correlated with sleep disorders. The overall SRBD scores and SDSC T scores of CP children were negatively correlated with QOL (r =  −0.489, p < 0.001 and r =  −0.445, p < 0.001, respectively).

Conclusion

Sleep disorders are more common in CP which adversely affect QOL. Routine screening and appropriate treatment are suggested.

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References

  1. Owens J. Classification and epidemiology of childhood sleep disorders. Prim Care. 2008;35:533–46.

    Article  PubMed  Google Scholar 

  2. Newman CJ, O'Regan M, Hensey O. Sleep disorders in children with cerebral palsy. Dev Med Child Neurol. 2006;48:564–8.

  3. Rosen CL, Larkin EK, Kirchner HL, et al. Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity. J Pediatr. 2003;142:383–9.

    Article  PubMed  Google Scholar 

  4. Fitzgerald DA, Follett J, Van Asperen PP. Assessing and managing lung disease and sleep disordered breathing in children with cerebral palsy. Paediatr Respir Rev. 2009;10:18–24.

  5. Elsayed RM, Hasanein BM, Sayyah HE, El-Auoty MM, Tharwat N, Belal TM. Sleep assessment of children with cerebral palsy: Using validated sleep questionnaire. Ann Indian Acad Neurol. 2013;16:62–5.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Varni JW, Burwinkle TM, Sherman SA, et al. Health-related quality of life of children and adolescents with cerebral palsy: hearing the voices of the children. Dev Med Child Neurol. 2005;47:592–7.

    Article  PubMed  Google Scholar 

  7. Sandella DE, O’Brien LM, Shank LK, Warschausky SA. Sleep and quality of life in children with cerebral palsy. Sleep Med. 2011;12:252–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pediatric Sleep Questionnaire—Designed as Research Screen for Symptoms of Obstructive Sleep Apnea and Other Sleep Disorders in Children. Available at: https://umich.flintbox.com/technologies/99AFF626F4D94529AA3AA509ED8EC905. Accessed on 4 Sep 2017.

  9. Schneider JW, Gurucharri LM, Gutierrez AL, Gaebler-Spira DJ. Health-related quality of life and functional outcome measures for children with cerebral palsy. Dev Med Child Neurol. 2001;43:601–8.

    Article  CAS  PubMed  Google Scholar 

  10. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8–14.

    PubMed  Google Scholar 

  11. Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000;1:21–32.

    Article  CAS  PubMed  Google Scholar 

  12. Sleep-Related Breathing Disorder Scale (SRBD Scale), from Pediatric Sleep Questionnaire, to Identify Symptoms of Obstructive Sleep Apnea in Children. Available at: https://umich.flintbox.com/technologies/c483f806-fbf5-427a-b141-67211985e4e9. Accessed on 4 Sep 2017.

  13. Bruni O, Ottaviano S, Guidetti V, et al. The sleep disturbance scale for children (SDSC). Construction and validation of an instrument to evaluate sleep disturbance in childhood and adolescence. J Sleep Res.1996;5:251–61.

  14. Waters E, Maher E, Salmon L, Reddihough D, Boyd R. Development of a condition-specific measure of quality of life for children with cerebral palsy: empirical thematic data reported by parents and children. Child Care Health Dev. 2005;31:127–35.

    Article  CAS  PubMed  Google Scholar 

  15. Zarowski M, Mojs E, Gajewska E, Steinborn B, Samborski W. Prevalence of sleep problems in children with cerebral palsy. Preliminary study. Ann Acad Med Stetin. 2008;54:59–64.

  16. Romeo DM, Brogna C, Musto E, et al. Sleep disturbances in preschool age children with cerebral palsy: a questionnaire study. Sleep Med. 2014;15:1089–93.

    Article  PubMed  Google Scholar 

  17. Munyumu K, Idro R, Abbo C, et al. Prevalence and factors associated with sleep disorders among children with cerebral palsy in Uganda; a cross-sectional study. BMC Pediatr. 2018;18:26.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Horwood L, Mok E, Li P, Oskoui M, Shevell M, Constantin E. Prevalence of sleep problems and sleep related characteristics in preschool and school aged children with cerebral palsy. Sleep Med. 2018;50:1–6.

    Article  PubMed  Google Scholar 

  19. Adiga D, Gupta A, Khanna M, Taly AB, Thennarasu K. Sleep disorders in children with cerebral palsy and its correlation with sleep disturbance in primary caregivers and other associated factors. Ann Indian Acad Neurol. 2014;17:473–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Michael V Johnston. Cerebral palsy. In: Kliegman RH, Stanton BF, Geme JW, Schor NF, Behrman RE, editors. Nelson Textbook of Pediatrics. Philadelphia; Elsevier. 2016. p.2896–9.

  21. Tella BA, Gbiri CA, Osho OA, Ogunrinu AE. Health-related quality of life of Nigerian children with cerebral palsy. Disability, CBR & Inclusive Development. 2011;22:95–104.

  22. Gharaborghe SN, Sarhady M, Hosseini SMS, Mortazavi SS. Quality of life and gross motor function in children with cerebral Palsy (aged 4–12). Iran Rehabil J. 2015;13:58–62.

    Google Scholar 

  23. Tessier DW, Hefner JL, Newmeyer A. Factors related to psychosocial quality of life for children with cerebral palsy. Int J Pediatr. 2014;2014:204386.

  24. Dobhal M, Juneja M, Jain R, Sairam S, Thiagarajan D. Health-related quality of life in children with cerebral palsy and their families. Indian Pediatr. 2014;51:385–7.

  25. Das S, Aggarwal A, Roy S, Kumar P. Quality of life in Indian children with cerebral palsy using cerebral palsy-quality of life questionnaire. J Pediatr Neurosci. 2017;12:251–4.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Zuculo GM, Knap CC, Pinato L. Correlation between sleep and quality of life in cerebral palsy. Codas. 2014;26:447–56.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India

    Pramod Samota, Aaradhana Singh & Anju Aggarwal

  2. Scientist (Statistics), Delhi Cancer Registry, Dr. B.R. Ambedkar Institute Rotatory Cancer Hospital, AIIMS, New Delhi, India

    Rajeev Malhotra

Authors
  1. Pramod Samota
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  2. Aaradhana Singh
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  3. Anju Aggarwal
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  4. Rajeev Malhotra
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Contributions

PS, AS, AA, RM were involved in planning of protocol; Data collection was done by PS under supervision of AA and AS; Analysis, interpretation, drafting of manuscript and literature search involved all authors. AA will act as the guarantor for this paper.

Corresponding author

Correspondence to Aaradhana Singh.

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Ethics Approval

This study was approved by the Institutional Ethics Committee–Human Research (IES-HR), University College of Medical Science, Delhi (Approval No. IEC-HR/2017/32/95).

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Written informed consent was obtained from parents/guardians of all the participants.

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Samota, P., Singh, A., Aggarwal, A. et al. Sleep Disorders and Quality of Life in Children with Cerebral Palsy. Indian J Pediatr 90, 560–565 (2023). https://doi.org/10.1007/s12098-022-04151-x

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  • DOI: https://doi.org/10.1007/s12098-022-04151-x

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