Sleep disorders among children with cerebral palsy: characteristics and associated factors as reported by their mothers

Abstract

Background: Children with cerebral palsy (CP) are significantly more prone to sleep disturbances due to associated neurological, behavioral, and environmental challenges. These disorders not only impact their physical and cognitive development but also place a substantial burden on caregivers, particularly mothers, who are often the primary observers and caretakers. Objectives: This study aimed to explore the characteristics and associated factors of sleep disorders among children with cerebral palsy, as reported by their mothers. Methodology: A cross-sectional study was conducted at the Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, involving 104 mothers of children diagnosed with CP. Data were collected using the Sleep Disturbance Scale for Children (SDSC) and a structured sociodemographic and questionnaire. Convenience sampling was employed, and data were analyzed using SPSS version 25. Descriptive and inferential statistics, including chi-square tests, were used to identify associations between variables. Results: Among the children, 81% were aged 2–5 years and 57% were boy. Spastic quadriplegia was the most common CP type (39%), and 54% of children were classified as GMFCS level III. Notably, 37% of children exhibited signs of sleep disturbances, with insomnia and sleep-wake transition disorders being most prevalent. Significant associations were found between sleep disorders and factors such as epilepsy, use of anti-epileptic drugs, environmental conditions, hyperactivity before sleep, and fear of darkness or being alone. Discussion: The findings underscore a high prevalence of sleep disorders among children with CP, which are closely associated with clinical and environmental factors. Mothers’ perspectives provided crucial insights into the daily challenges and stressors faced in managing these conditions. Addressing these sleep issues through routine clinical assessment and tailored non-pharmacological interventions is essential for improving outcomes for both children and their caregivers. Keywords: Cerebral palsy, sleep disorders, Sleep Disturbance Scale for Children (SDSC), epilepsy, GMFCS.