Sleep disorders in children with cerebral palsy

Abstract

Recent studies on children with cerebral palsy indicate that this population is at a higher risk of sleep disorders. Although sleep dysfunction seems to be frequent in cerebral palsy, there are few studies assessing sleep dysfunction and its risk in children. Also, the prevalence of sleep apnea has not been formally assessed in children with cerebral palsy. Risk factors for sleep dysfunction include comorbid epilepsy, mental retardation, visual impairment and degree of functional motor impairment. Contractures and spasticity can adversely contribute to positioning during sleep. We analyzed motor, cognitive and functional impairment, as well as the existence of comorbidity and results of brain imaging and electroencephalography in 21 children with cerebral palsy and correlated them with the presence of sleep disorders. Sleep disorder was evaluated by electroencephalography/polysomnography. About 57% of children in our study had sleep disorders. The most common motor impairment was spastic diplegia. Most children had peri ventricular hyperintensities and cortical atrophy on neuroimaging. Diffi culty in initiating and maintaining sleep (microarousals), fragmented sleep, and sleep breathing disorders were frequently identifi ed problems and were evaluated by polysomnography. Children with abnormal electroencephalography had more sleep disturbances than those with normal electroencephalography. Disorders of initiation and maintenance of sleep were more frequent in children with spastic quadriplegia. It is known that the consequences of sleep disorders in children aff ect both the child and the family. Prospective studies in a larger sample and proper methodology are needed to determine whether improvement in sleep quality of children with cerebral palsy leads to improvement in their life quality.