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

Objectives: To 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.

Methods: Children 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.

Results: 150 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.

Conclusions: Sleep 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.