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

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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.

Keywords

Mental health Questionnaires Sleep disorders Anxiety Diagnostic and Statistical Manual of Mental Disorders 

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

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.

Schlüsselwörter

Psychische Gesundheit Fragebogen Schlafstörungen Angst Diagnostisches und Statistisches Manual Psychischer Störungen 

Notes

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.

Compliance with ethical guidelines

Conflict of interest

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.

References

  1. 1.
    Achenbach TM, Rescorla L (2000) Manual for the ASEBA preschool forms & profiles : an integrated system of multi-informant assessment. ASEBA, Burlington, VTGoogle Scholar
  2. 2.
    Arens R, Muzumdar H (2010) Sleep, sleep disordered breathing, and nocturnal hypoventilation in children with neuromuscular diseases. Paediatr Respir Rev 11:24–30CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Armitage P, Berry G, Matthews JNS (2001) Statistical methods in medical research, 4th edn. Blackwell Science, Malden, MAGoogle Scholar
  4. 4.
    Atmawidjaja RW, Wong SW, Yang WW, Ong LC (2014) Sleep disturbances in Malaysian children with cerebral palsy. Dev Med Child Neurol 56:681–685CrossRefPubMedGoogle Scholar
  5. 5.
    Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, Jacobsson B, Damiano D (2005) Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol 47:571–576CrossRefPubMedGoogle Scholar
  6. 6.
    Borenstein M, Hedges L, Higgins J, Rothstein H (2005) Comprehensive Meta-analysis Version 2. Biostat, Englewood, NJGoogle Scholar
  7. 7.
    Bottcher L (2010) Children with spastic cerebral palsy, their cognitive functioning, and social participation: A review. Child Neuropsychol 16:209–228CrossRefPubMedGoogle Scholar
  8. 8.
    Bottcher L, Flachs EM, Uldall P (2010) Attentional and executive impairments in children with spastic cerebral palsy. Dev Med Child Neurol 52:e42–e47CrossRefPubMedGoogle Scholar
  9. 9.
    Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. L. Erlbaum Associates, Hillsdale, N.JGoogle Scholar
  10. 10.
    Cross EM, Chaffin WW (1982) Use of the binomial theorem in interpreting results of multiple tests of significance. Educ Psychol Meas 42:25–34CrossRefGoogle Scholar
  11. 11.
    Einfeld SL, Ellis LA, Emerson E (2011) Comorbidity of intellectual disability and mental disorder in children and adolescents: A systematic review. J Intellect Dev Disabil 36:137–143CrossRefPubMedGoogle Scholar
  12. 12.
    Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191CrossRefPubMedGoogle Scholar
  13. 13.
    Fisher BC (2007) ADD/ADHD symptoms and daytime sleepiness in children. In: Fisher BC (ed) Attention deficit disorders practical coping mechanisms. Informa Healthcare, New York; London, pp 131–133Google Scholar
  14. 14.
    Gelman A, Hill J (2007) Data analysis using regression and multilevel/hierarchical models. Cambridge University Press, Cambridge ; New YorkGoogle Scholar
  15. 15.
    Gregory AM, O’Connor TG (2002) Sleep problems in childhood: A longitudinal study of developmental change and association with behavioral problems. J Am Acad Child Adolesc Psychiatry 41:964–971CrossRefPubMedGoogle Scholar
  16. 16.
    Hayashi M, Inoue Y, Iwakawa Y, Sasaki H (1990) REM sleep abnormalities in severe athetoid cerebral palsy. Brain Dev 12:494–497CrossRefPubMedGoogle Scholar
  17. 17.
    Hemmingsson H, Stenhammar A‑M, Paulsson K (2009) Sleep problems and the need for parental night-time attention in children with physical disabilities. Child Care Health Dev 35:89–95CrossRefPubMedGoogle Scholar
  18. 18.
    Hill CM, Hogan AM, Karmiloff-Smith A (2007) To sleep, perchance to enrich learning? Arch Dis Child 92:637–643CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Kolmagorova AV, Slobodskaya ER, Kinscht IA (2007) Mental health assessment in early childhood. Bull Siberian Branch Russ Acad Med 125:46–52 (in Russian)Google Scholar
  20. 20.
    Kotu V, Deshpande B (2015) Predictive analytics and data mining: Concepts and practice with rapidminer, 1st edn. Elsevier, Amsterdam; Boston; Heidelberg; London; New York; Oxford; Paris; San Diego; San Francisco; Singapore; Sydney; TokyoGoogle Scholar
  21. 21.
    Marks JH (2008) Pulmonary care of children and adolescents with developmental disabilities. Pediatr Clin North Am 55:1299–1314CrossRefPubMedGoogle Scholar
  22. 22.
    Mol E, Monbaliu E, Ven M, Vergote M, Prinzie P (2012) The use of night orthoses in cerebral palsy treatment: Sleep disturbance in children and parental burden or not? Res Dev Disabil 33:341–349CrossRefPubMedGoogle Scholar
  23. 23.
    Newman CJ, O’Regan M, Hensey O (2006) Sleep disorders in children with cerebral palsy. Dev Med Child Neurol 48:564–568CrossRefPubMedGoogle Scholar
  24. 24.
    O’Brien LM, Gozal D (2004) Neurocognitive dysfunction and sleep in children: From human to rodent. Pediatr Clin 51:187–202CrossRefGoogle Scholar
  25. 25.
    O’Brien G, White P (2014) Behaviour and mental health. In: Dan B, Mayston M, Paneth N, Rosenbloom L (eds) Cerebral palsy: Science and clinical practice. Mac Keith Press, London, pp 565–578Google Scholar
  26. 26.
    Odding E, Roebroeck ME, Stam HJ (2006) The epidemiology of cerebral palsy: Incidence, impairments and risk factors. Disabil Rehabil 28:183–191CrossRefPubMedGoogle Scholar
  27. 27.
    Owens JA, Spirito A, McGuinn M, Nobile C (2000) Sleep habits and sleep disturbance in elementary school-aged children. J Dev Behav Pediatr 21:27–36CrossRefPubMedGoogle Scholar
  28. 28.
    Richdale AL, Francis A, Gavidia-Payne S, Cotton S (2000) Stress, behaviour, and sleep problems in children with an intellectual disability. J Intellect Dev Disabil 25:147–161CrossRefGoogle Scholar
  29. 29.
    Romeo DM, Brogna C, Quintiliani M, Baranello G, Pagliano E, Casalino T, Sacco A, Ricci D, Mallardi M, Musto E (2014) Sleep disorders in children with cerebral palsy: Neurodevelopmental and behavioral correlates. Sleep Med 15:213–218CrossRefPubMedGoogle Scholar
  30. 30.
    Sandella DE, O’Brien LM, Shank LK, Warschausky SA (2011) Sleep and quality of life in children with cerebral palsy. Sleep Med 12:252–256CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Scheck SM, Boyd RN, Rose SE (2012) New insights into the pathology of white matter tracts in cerebral palsy from diffusion magnetic resonance imaging: A systematic review. Dev Med Child Neurol 54:684–696CrossRefPubMedGoogle Scholar
  32. 32.
    Shibagaki M, Kiyono S, Takeuchi T (1985) Nocturnal sleep in mentally retarded infants with cerebral palsy. Electroencephalogr Clin Neurophysiol 61:465–471CrossRefPubMedGoogle Scholar
  33. 33.
    Shintani T, Asakura K, Ishi K, Yoshida M, Kataura A, Ogasawara H (1998) Obstructive sleep apnea in children with cerebral palsy. Nippon Jibiinkoka Gakkai Kaiho 101:266–271CrossRefPubMedGoogle Scholar
  34. 34.
    Simard-Tremblay E, Constantin E, Gruber R, Brouillette RT, Shevell M (2011) Sleep in children with cerebral palsy: A review. J Child Neurol 26:1303–1310CrossRefPubMedGoogle Scholar
  35. 35.
    Simonoff E, Pickles A, Wood N, Gringras P, Chadwick O (2007) ADHD symptoms in children with mild intellectual disability. J Am Acad Child Adolesc Psychiatry 46:591–600CrossRefPubMedGoogle Scholar
  36. 36.
    Sipal R, Schuengel C, Voorman J, Van Eck M, Becher J (2010) Course of behaviour problems of children with cerebral palsy: The role of parental stress and support. Child Care Health Dev 36:74–84CrossRefPubMedGoogle Scholar
  37. 37.
    Stern Y (2009) Cognitive reserve. Neuropsychologia 47:2015–2028CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Svedberg LE, Englund E, Malker H, Stener-Victorin E (2008) Parental perception of cold extremities and other accompanying symptoms in children with cerebral palsy. Eur J Paediatr Neurol 12:89–96CrossRefPubMedGoogle Scholar
  39. 39.
    Tamm L, Menon V, Reiss AL (2002) Maturation of brain function associated with response inhibition. J Am Acad Child Adolesc Psychiatry 41:1231–1238CrossRefPubMedGoogle Scholar
  40. 40.
    Wayte S, McCaughey E, Holley S, Annaz D, Hill CM (2012) Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatr 101:618–623CrossRefPubMedGoogle Scholar
  41. 41.
    White DA, Christ SE (2005) Executive control of learning and memory in children with bilateral spastic cerebral palsy. J Int Neuropsychol Soc 11:920–924CrossRefPubMedGoogle Scholar
  42. 42.
    Wiggs L, Stores G (1996) Severe sleep disturbance and daytime challenging behaviour in children with severe learning disabilities. J Intellect Disabil Res 40:518–528CrossRefPubMedGoogle Scholar
  43. 43.
    Wiggs L, Stores G (1998) Behavioural treatment for sleep problems in children with severe learning disabilities and challenging daytime behaviour: effect on sleep patterns of mother and child. J Sleep Res 7:119–126CrossRefPubMedGoogle Scholar
  44. 44.
    Wiggs L, France K (2000) Behavioural treatments for sleep problems in children and adolescents with physical illness, psychological problems or intellectual disabilities. Sleep Med Rev 4:299–314CrossRefPubMedGoogle Scholar
  45. 45.
    Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P, Translation ITFf, Cultural A (2005) Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health 8:94–104CrossRefPubMedGoogle Scholar
  46. 46.
    Winter S, Autry A, Boyle C, Yeargin-Allsopp M (2002) Trends in the prevalence of cerebral palsy in a population-based study. Pediatrics 110:1220–1225CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Institute of Special Education and Special Psychology of the Raoul Wallenberg International University for Family and ChildSt. PetersburgRussian Federation
  2. 2.St. Petersburg State Institute of Psychology and Social WorkSt. PetersburgRussian Federation

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