Sleep disorders and associated factors in children with cerebral palsy

Main Article Content

Sari Wardhani Mahligai Patery
Sunartini Sunartini
Retno Sutomo

Abstract

Background Sleep disorders are a condition affecting quality and quantity of sleep. Children with cerebral palsy (CP) have higher risk of sleep disorders than those with no chronic disease.


Objective To determine the prevalence and factors associated with sleep disorders in children with CP.


Methods We conducted an analytic, observational study with cross-sectional design in children aged 4-10 years with CP. Subjects were recruited consecutively; children with chronic diseases (cardiovascular, malignancy, chronic obstructive pulmonary disease, and diabetes mellitus) were excluded from the study. Primary data including sociodemographics, intensity of physiotherapy outside Sardjito General Hospital (SGH), sleep hygiene, and sleep disorders were collected from the Children’s Sleep Habit Questionnaire (CSHQ). Secondary data were acquired from medical records, such as type of CP, severity of motor function impairment, presence of epilepsy, intensity of physiotherapy performed at SGH, as well as anti-epileptic, anti-spastic, and sleep-affecting medicines.


Results We found sleep disorders in 64 of 75 (85%) subjects, mostly bedtime resistance (66%). Spastic quadriplegia (OR=3.63; 95%CI 1.82 to15.94) and presence of epilepsy (OR=7.82; 95%CI 1.53 to 39.84) were significantly associated with sleep disorders in children with CP aged 4-10 years.


Conclusion Sleep disorders are common in children with CP, with the majority experiencing bedtime resistance. Sleep disorders are more prevalent in subjects with spastic quadriplegia and epilepsy.

Article Details

How to Cite
1.
Patery S, Sunartini S, Sutomo R. Sleep disorders and associated factors in children with cerebral palsy. PI [Internet]. 16Aug.2021 [cited 23Sep.2021];61(4):179-5. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2439
Section
Developmental Behavioral & Community Pediatrics
Received 2020-06-26
Accepted 2021-08-16
Published 2021-08-16

References

1. Roehrs T. Sleep physiology and pathophysiology. Clin Cornerstone. 2000;2:1-12. DOI: 10.1016/s1098-3597(00)90036-x.
2. Selina H, Priambodo WS, Sakundarno M. Gangguan tidur pada anak palsi serebral. Med Hosp. 2012;1:108–12. DOI:10.36408/mhjcm.v1i2.54
3. The definition and classification of cerebral palsy. Dev Med Child Neurol. 2007 Feb;49(s109):1-44. DOI: 10.1111/j.1469-8749.2007.00001.x.
4. Simard-Tremblay E, Constantin E, Gruber R, Brouillette RT, Shevell M. Sleep in children with cerebral palsy: a review. J Child Neurol. 2011;26:1303–10. DOI: 10.1177/0883073811408902.
5. Dutt R, Roduta-Roberts M, Brown CA. Sleep and children with cerebral palsy: a review of current evidence and environmental non-pharmacological interventions. Children (Basel). 2015;2:78–88. DOI:10.3390/children2010078.
6. Galland BC, Elder DE, Taylor BJ. Interventions with a sleep outcome for children with cerebral palsy or a post-traumatic brain injury: a systematic review. Sleep Med Rev. 2012;16:561–73. DOI:10.1016/j.smrv.2012.01.007.
7. LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics. 2005;115(Supp.1):257-65. DOI:10.1542/peds.2004-0815H. PMID: 15866860; PMCID: PMC3928632.
8. Free Health Encyclopedia. Sleep disorders. 2007. [cited 2020 June 20]. Available from http://www.faqs.org/health/Sick-V4/Sleep-Disorders.html
9. Munyumu K, Idro R, Abbo C, Kaddumukasa M, Katabira E, Mupere E, 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. DOI:10.1186/s12887-018-0996-z.
10. Newman CJ, O’Regan M, Hensey O. Sleep disorders in children with cerebral palsy. Dev Med Child Neurol. 2006;48:564–8. DOI:10.1017/S0012162206001198.
11. Legros B, Bazil CW. Effects of antiepileptic drugs on sleep architecture: a pilot study. Sleep Med. 2003;4:51–5. DOI:10.1016/s1389-9457(02)00217-4.
12. Romeo DM, Brogna C, Musto E, Baranello G, Pagliano E, Casalino T, et al. Sleep disorders in preschool age children with cerebral palsy: a questionnaire study. Sleep Med. 2014;15:1089–93. DOI:10.1016/j.sleep.2014.05.008.
13. Hartini S, Sunartini, Herini SE, Takada S. Item Analysis and Internal Consistency of Children's Sleep Habit Questionnaire (CHSQ) in Indonesian Version. Belitung Nursing Journal. 2017;3(6):645-655.
14. Palisano R, Rosenbaum P, Bartlett D, Livingston M. Gross Motor Function Classification System Expanded and Revised. CanChild Centre for Childhood Disability Research, McMaster University. 2007. [cited 2020 June 20]. Available from: https://canchild.ca/en/resources/42-gross-motor-function-classification-system-expanded-revised-gmfcs-e-r.
15. Russo RN, Miller MD, Haan E, Cameron ID, Crotty M. Pain characteristics and their association with quality of life and self-concept in children with hemiplegic cerebral palsy identified from a population register. Clin J Pain. 2008;24:335–42. DOI: 10.1097/AJP.0b013e318162eae0.
16. Shamsoddini A, Amirsalari S, Hollisaz MT, Rahimniya A, Khatibi-Aghda A. Management of spasticity in children with cerebral palsy. Iran J Pediatr. 2014;24:345–51.
17. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2018;171:897–907. DOI:10.1001/jamapediatrics.2017.1689.
18. Wayte S, McCaughey E, Holley S, Annaz D, Hill CM. Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatr. 2012;101:618–23. DOI:10.1111/j.1651-2227.2012.02603.x.
19. CW. Epilepsy and sleep disturbance. Epilepsy Behav. 2003;4 Suppl 2:S39-45. DOI: 10.1016/j.yebeh.2003.07.005.
20. Paprocka J, Kijonka M, Sokół M. Melatonin in childhood epilepsy and in child neurology. DOI: 10.5772/intechopen.80005.
21. Coogan A, Baird A, Popa-Wagner A, Thome J. Circadian rhytms and attention deficit hyperactivity disorder: the what, the when, and the why. Prog Neuropsychopharmacology Biol Psychiatry. 2016; 67:74-81. DOI: 10.1016/j.pnpbp.2016.01.006.
22. Adiga A, Gupta A, Khanna M, Taly A, Thennarasu K. Sleep disorders in children with cerebral palsy and its correlation with sleep disorders in primary caregivers and other associated factors. Ann Indian Acad Neurol. 2014;17:473-6. DOI:10.4103/0972-2327.144044.
23. Malow BA. Sleep deprivation and epilepsy. Epilepsy Curr. 2004;4:193–5. DOI: 10.1111/j.1535-7597.2004.04509.x.
24. Chung CY, Chen CL, Wong AMK. Pharmacotherapy of spasticity in children with cerebral palsy. J Formos Med Assoc. 2011;110:215–22. DOI:10.1016/S0929-6646(11)60033-8.
25. Pervin R, Ahmed S, Hyder RT, Yasmeen BHN, Rahman M, Islam F. Cerebral palsy-an update. North Int Med Coll J. 2013;5:293–6. DOI:10.3329/nimcj.v5i1.23115.
26. Atmawidjaja RW, Wong SW, Yang WW, Ong LC. Sleep disorders in Malaysian children with cerebral palsy. Dev Med Child Neurol. 2014;56:681–5. DOI:10.1111/dmcn.12399.
27. Latz S, Wolf A, Lozoff B. Cosleeping in context: sleep practices and problems in young children in Japan and the United States. Arch Pediatr Adolesc Med. 1999;153:339–46. DOI:10.1001/archpedi.153.4.339.
28. Mindell J, Sadeh A, Kohyama J, How T. Parental behaviours and sleep outcomes in infant and toddlers: A cross-cultural comparison. Sleep Med. 2010;11:393–9. DOI:10.1016/j.sleep.2009.11.011.
29. Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12:785–6. DOI:10.5664/jcsm.5866.
30. Schwichtenberg AJ, Goodlin-Jones B. Causes and correlates of frequent night awakenings in early childhood. International Review of Neurobiology. 2010;93. DOI:10.1016/S0074-7742(10)93008-0.
31. Moturi S, Avis K. Assessment and treatment of common pediatric sleep disorders. Psychiatry (Edgmont). 2010;7:24–37. PMID: 20622943.
32. Bayer L, Constantinescu I, Perrig S, Vienne J, Vidal P-P, Muhlethaler M, et al. Rocking synchronizes brain waves during a short nap. Curr Biol. 2011;21:R461-2. DOI: 10.1016/j.cub.2011.05.012.