Sleep Quality in Mothers of Children with Cerebral Palsy: The Relationship between Children’s Gross Motor Function, Sleep Habits
Year 2022,
Volume: 9 Issue: 1, 248 - 263, 30.04.2022
Ayşenur Tuncer
,
Hazel Çelik Güzel
,
Asiye Uzun
,
Elif Dilan Atılgan
Abstract
Purpose: The aim of this study was to investigate the relationship between the sleep habits and gross motor skill level of children with cerebral palsy and the sleep quality of their mothers.
Materials and Methods: Evaluation was made of 83 children, aged 3-18 years, with different clinical types of cerebral palsy and varying physical capabilities, and their mothers who were the carers. In the rehabilitation centres of three different cities, the children were evaluated with the Gross Motor Function Classification Scale (GMFCS) and the Children’s Sleep Habits Questionnaire (CSHQ), and the sleep quality of their mothers with the Pittsburgh Sleep Quality Index (PSQİ).
Results: The sleep problems of 86% of the children and 84% of the mothers were determined to be poor sleep quality. The GMFCS was found to be correlated with the CSHQ (p=0.002), but not with the sleep quality of the mothers (p=0.164). A statistically significant positive correlation was determined between the PSQI score of the mothers and the total CSHQ score of the children (r=0.259, p=0.018). No statistically significant correlation was determined between the PSQI and the total sleep and waking at night scores (r=-0.087, p=0.433; r=-0.058, p=0.600).
Conclusions: The sleep quality of the mothers was determined to be affected by the sleep habits of their children with cerebral palsy. Poor sleep quality can be physically and psychologically destructive in the long term for mothers who are providing care. It is therefore essential that support services related to the sleep quality of mothers are further developed.
Supporting Institution
The authors did not receive any financial support for this study.
Project Number
Human Research Ethics Committee of Hasan Kalyoncu University, Turkey (protocol number: 2020/035, dated 28.05.2020)
References
- Adiga, D., Gupta, A., Khanna, M., Taly, A. B., & Thennarasu, K. (2014). Sleep disorders in children with cerebral palsy and its correlation with sleep disturbance in primary caregivers and other associated factors. Annals of Indian Academy of Neurology, 17(4), 473–476. https://doi.org/10.4103/0972-2327.144044
- Ağargün, M. Y., Kara, H., & Anlar, Ö. (1996). Pittsburgh Uyku Kalitesi İndeksi'nin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi, 7(2), 107-111.
- Albayrak, I., Biber, A., Çalışkan, A., & Levendoglu, F. (2019). Assessment of pain, care burden, depression level, sleep quality, fatigue and quality of life in the mothers of children with cerebral palsy. Journal of Child Health Care, 23(3), 483–494. https://doi.org/10.1177/1367493519864751
- Atmawidjaja, R. W., Wong, S. W., Yang, W. W., & Ong, L. C. (2014). Sleep disturbances in Malaysian children with cerebral palsy. Developmental Medicine and Child Neurology, 56(7), 681–685. https://doi.org/10.1111/dmcn.12399
- Bourke-Taylor, H., Pallant, J. F., Law, M., & Howie, L. (2013). Relationships between sleep disruptions, health and care responsibilities among mothers of school-aged children with disabilities. Journal of Paediatrics and Child Health, 49(9), 775–782. https://doi.org/10.1111/jpc.1225
- Brossard-Racine, M., Hall, N., Majnemer, A., Shevell, M. I., Law, M., Poulin, C., et al. (2012). Behavioural problems in school age children with cerebral palsy. European Journal of Paediatric Neurology, 16(1), 35–41. https://doi.org/10.1016/j.ejpn.2011.10.001
- da Silva, T., Silva, A. M., Alvarenga, E., Nogueira, B. R., Prado, R. R., & Mendes, R. F. (2020). Risk factors associated with probable sleep bruxism of children and teenagers with cerebral palsy. The Journal of Clinical Pediatric Dentistry, 44(4), 228–233. https://doi.org/10.17796/1053-4625-44.4.3
- Erdoğanoğlu, Y., Kerem-Günel, M. (2007). Serebral Paralizili Çocukların Ailelerinin Sağlıkla İlgili Yaşam Kalitelerini Araştırılması, Toplum Hekimliği Bülteni,26(2), 35-39.
- Faul, F., Erdfelder, E., Buchner, A., & Lang, A.G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
- Fiş, N. P., Arman, A., AY, P., Topuzoğlu, A., Güler, A.S., & Gökçe, S. (2010). Çocuk Uyku Alışkanlıkları Anketinin Türkçe geçerliliği ve güvenilirliği. Anadolu Psikiyatri Dergisi, 11(2), 151-60.
- Halstead, E. J., Joyce, A., Sullivan, E., Tywyn, C., Davies, K., Jones, et al. (2021). Sleep disturbances and patterns in children with neurodevelopmental conditions. Frontiers in Pediatrics, 9, 637770. https://doi.org/10.3389/fped.2021.637770
- Haylı, Ç.M. (2022). Zihinsel Engelli Çocuklar ve Annelerinde Uyku Sorunları ve Çözüm Önerileri. J Turk Sleep Med. 9:1-4.
- 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 and Development, 35(1), 89–95. https://doi.org/10.1111/j.1365-2214.2008.00907.x
- Honomichl, R. D., Goodlin-Jones, B. L., Burnham, M., Gaylor, E., & Anders, T. F. (2002). Sleep patterns of children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 32(6), 553–561. https://doi.org/10.1023/a:1021254914276
- Horwood, L., Li, P., Mok, E., Shevell, M., & Constantin, E. (2019). A systematic review and meta-analysis of the prevalence of sleep problems in children with cerebral palsy: how do children with cerebral palsy difer from each other and from typically developing children? Sleep Health, 5(6), 555–571. https://doi.org/10.1016/j.sleh.2019.08.006
- Kerem, G. M., Mutlu, A., Livanelioglu, A., El, O., Baydar, M., Peker, O. et al. Turkish Expanded and Revised Gross Motor Function Classification System [Internet]. http://canchild- mgm.icreate3.esolutionsgroups.ca/en/GMFCS/resources/ GMFCS-ER.pdf.
- Khayatzadeh, M. M., Rostami, H. R., Amirsalari, S., & Karimloo, M. (2013). Investigation of quality of life in mothers of children with cerebral palsy in Iran: association with socio-economic status, marital satisfaction and fatigue. Disability and Rehabilitation, 35(10), 803–808. https://doi.org/10.3109/09638288.2012.708818
- Lang, C. P., Boucaut, A., Guppy, M., & Johnston, L. M. (2021). Children with cerebral palsy: A cross-sectional study of their sleep and their caregiver's sleep quality, psychological health and well-being. Child: Care, Health and Development, 47(6), 859–868. https://doi.org/10.1111/cch.12897
- Lee, J. (2013). Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: A literature review. Research in Developmental Disabilities, 34(11), 4255–4273. https://doi.org/10.1016/j.ridd.2013.09.008
- Manfredini, D., Restrepo, C., Diaz-Serrano, K., Winocur, E., & Lobbezoo, F. (2013). Prevalence of sleep bruxism in children: A systematic review of the literature. Journal of Oral Rehabilitation, 40(8), 631–642. https://doi.org/10.1111/joor.12069
- Mannion, A., & Leader, G. (2014). Sleep problems in autism spectrum disorder: A literatur review. Journal of Autism and Developmental Disorders, 1(Supp 2), 101-109. https://doi.org/ 10.1007/s40489-013-0009-y
- Matsuoka, M., Nagamitsu, S., Iwasaki, M., Iemura, A., Yamashita, Y., Maeda, M., et al. (2014). High incidence of sleep problems in children with developmental disorders: results of a questionnaire survey in a Japanese elementary school. Brain and Development, 36(1), 35–44. https://doi.org/10.1016/j.braindev.2012.12.004
- Mörelius, E., & Hemmingsson, H. (2014). Parents of children with physical disabilities - perceived health in parents related to the child's sleep problems and need for attention at night. Child: Care, Health and Development, 40(3), 412–418. https://doi.org/10.1111/cch.12079
- Newman, C. J., O'Regan, M., & Hensey, O. (2006). Sleep disorders in children with cerebral palsy. Developmental Medicine and Child Neurology, 48(7), 564–568. https://doi.org/10.1017/S0012162206001198
- Ortega, A. O., Guimarães, A. S., Ciamponi, A. L., & Marie, S. K. (2007). Frequency of parafunctional oral habits in patients with cerebral palsy. Journal of Oral Rehabilitation, 34(5), 323–328. https://doi.org/10.1111/j.1365-2842.2006.01703.x
- Owens, J. A., Spirito, A., & McGuinn, M. (2000). The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043–1051.
- Raina, P., O'Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., et al. (2005). The health and well-being of caregivers of children with cerebral palsy. Pediatrics, 115(6), e626–e636.https://doi.org/10.1542/peds.2004-1689.
- Rassafiani, M., Kahjoogh, M. A, Hosseini, & Sahaf, A. R. (2012). Time use in mothers of children with cerebral palsy: A comparison study. Hong Kong Journal of Occupational Therapy, 22(2): 70–74. https://doi.org/10.1016/j.hkjot.2012.11.001
- Restrepo, C., Manfredini, D., Castrillon, E., Svensson, P., Santamaria, A., Alvarez, C., et al. (2017). Diagnostic accuracy of the use of parental-reported sleep bruxism in a polysomnographic study in children. International Journal of Paediatric Dentistry, 27(5), 318–325. https://doi.org/10.1111/ipd.12262
- Richdale, A., & Wiggs, L. (2005). Behavioral approaches to the treatment of sleep problems in children with developmental disorders: What is the state of the art? International Journal of Behavioral Consultation and Therapy, 1(3), 165-190. http://dx.doi.org/10.1037/h0100743
- Romeo, D. M., Brogna, C., Quintiliani, M., Baranello, G., Pagliano, E., Casalino, T. et al. (2014). Sleep disorders in children with cerebral palsy: neurodevelopmental and behavioral correlates. Sleep Medicine, 15(2), 213–218. https://doi.org/10.1016/j.sleep.2013.08.793
- Romeo, D. M., Cioni, M., Distefano, A., Battaglia, L. R., Costanzo, L., Ricci, D. et al. (2010). Quality of life in parents of children with cerebral palsy: is it influenced by the child's behaviour? Neuropediatrics, 41(3), 121–126. https://doi.org/10.1055/s-0030-1262841
- Sarı, H.Y. (2010). Zihinsel yetersizliği olan çocuklarda uyku sorunları. Yeni Tıp Dergisi. 27 (3): 151-155.
- Takano, T., Hayashi, A., & Harada, Y. (2020). Progression of motor disability in cerebral palsy: the role of concomitant epilepsy. Seizure, 80, 81–85. https://doi.org/10.1016/j.seizure.2020.06.014
- Wayte, S., McCaughey, E., Holley, S., Annaz, D., & Hill, C. M. (2012). Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatrica, 101(6), 618–623. https://doi.org/10.1111/j.1651-2227.2012.02603.x
- Wright, M., Tancredi, A., Yundt, B., & Larin, H. (2006). Sleep issues in children with physical disabilities and their families. Physical & Occupational Therapy in Pediatrics, 26(3), 55–72. https://doi.org/10.1080/J006v26n03_05
Serebral Palsi’li Çocuğu olan Annelerin Uyku Kalitesi: Çocukların Kaba Motor Fonksiyonu ve Uyku Alışkanlıkları ile İlişkisi
Year 2022,
Volume: 9 Issue: 1, 248 - 263, 30.04.2022
Ayşenur Tuncer
,
Hazel Çelik Güzel
,
Asiye Uzun
,
Elif Dilan Atılgan
Abstract
Amaç: Bu çalışmanın amacı, serebral palsi’li çocukların uyku alışkanlıkları ve kaba motor seviyeleri ile annelerin uyku kaliteleri arasındaki ilişkinin araştırılmasıdır.
Gereç ve Yöntemler: Yaşları 3 ila 18 arasında değişen fiziksel yetersizliklere sahip 83 farklı klinik tipte serebral palsi'li çocuk ve onların bakımından sorumlu annelerine değerlendirme yapıldı. Üç farklı şehirdeki rehabilitasyon merkezlerinde değerlendirilen çocukların motor seviyeleri Kaba Motor Fonksiyon Sınıflandırma Ölçeği (KMFS), uyku alışkanlıkları Çocuk Uyku Alışkanlıkları (ÇUA) anketi ve annelerin uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ile değerlendirildi.
Bulgular: Çocukların %86'sında uyku sorunları, annelerin %84’ünde kötü uyku kalitesi tespit edildi. KMFS, ÇUA ile ilişkili bulunurken (p=0.002), annelerin uyku kalitesi ile ilişki bulunmadı (p=0.164). Annelerin PUKİ skoru ile çocukların ÇUA skoru arasında istatistiksel olarak anlamlı ve aynı yönlü pozitif bir korelasyon mevcuttu (r=0.259 ve p=0.018). PUKİ ile cocukların toplam uyku süresi ve gece uyanma skoru arasında istatistiksel olarak anlamlı korelasyon bulunmadı (r=-0.087, p=0.433; r=-0.058, p=0.600).
Sonuç: Annelerin uyku kalitesinin serebral palsi’li çocukların uyku alışkanlıklarından etkilendiği tespit edildi. Kötü uyku kalitesi, bakım veren anneler için uzun vadede fiziksel ve psikolojik yönden yıpratıcı olabilir. Annelerin uyku kalitesine yönelik destek hizmetlerinin daha da geliştirilmesi esastır.
Project Number
Human Research Ethics Committee of Hasan Kalyoncu University, Turkey (protocol number: 2020/035, dated 28.05.2020)
References
- Adiga, D., Gupta, A., Khanna, M., Taly, A. B., & Thennarasu, K. (2014). Sleep disorders in children with cerebral palsy and its correlation with sleep disturbance in primary caregivers and other associated factors. Annals of Indian Academy of Neurology, 17(4), 473–476. https://doi.org/10.4103/0972-2327.144044
- Ağargün, M. Y., Kara, H., & Anlar, Ö. (1996). Pittsburgh Uyku Kalitesi İndeksi'nin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi, 7(2), 107-111.
- Albayrak, I., Biber, A., Çalışkan, A., & Levendoglu, F. (2019). Assessment of pain, care burden, depression level, sleep quality, fatigue and quality of life in the mothers of children with cerebral palsy. Journal of Child Health Care, 23(3), 483–494. https://doi.org/10.1177/1367493519864751
- Atmawidjaja, R. W., Wong, S. W., Yang, W. W., & Ong, L. C. (2014). Sleep disturbances in Malaysian children with cerebral palsy. Developmental Medicine and Child Neurology, 56(7), 681–685. https://doi.org/10.1111/dmcn.12399
- Bourke-Taylor, H., Pallant, J. F., Law, M., & Howie, L. (2013). Relationships between sleep disruptions, health and care responsibilities among mothers of school-aged children with disabilities. Journal of Paediatrics and Child Health, 49(9), 775–782. https://doi.org/10.1111/jpc.1225
- Brossard-Racine, M., Hall, N., Majnemer, A., Shevell, M. I., Law, M., Poulin, C., et al. (2012). Behavioural problems in school age children with cerebral palsy. European Journal of Paediatric Neurology, 16(1), 35–41. https://doi.org/10.1016/j.ejpn.2011.10.001
- da Silva, T., Silva, A. M., Alvarenga, E., Nogueira, B. R., Prado, R. R., & Mendes, R. F. (2020). Risk factors associated with probable sleep bruxism of children and teenagers with cerebral palsy. The Journal of Clinical Pediatric Dentistry, 44(4), 228–233. https://doi.org/10.17796/1053-4625-44.4.3
- Erdoğanoğlu, Y., Kerem-Günel, M. (2007). Serebral Paralizili Çocukların Ailelerinin Sağlıkla İlgili Yaşam Kalitelerini Araştırılması, Toplum Hekimliği Bülteni,26(2), 35-39.
- Faul, F., Erdfelder, E., Buchner, A., & Lang, A.G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
- Fiş, N. P., Arman, A., AY, P., Topuzoğlu, A., Güler, A.S., & Gökçe, S. (2010). Çocuk Uyku Alışkanlıkları Anketinin Türkçe geçerliliği ve güvenilirliği. Anadolu Psikiyatri Dergisi, 11(2), 151-60.
- Halstead, E. J., Joyce, A., Sullivan, E., Tywyn, C., Davies, K., Jones, et al. (2021). Sleep disturbances and patterns in children with neurodevelopmental conditions. Frontiers in Pediatrics, 9, 637770. https://doi.org/10.3389/fped.2021.637770
- Haylı, Ç.M. (2022). Zihinsel Engelli Çocuklar ve Annelerinde Uyku Sorunları ve Çözüm Önerileri. J Turk Sleep Med. 9:1-4.
- 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 and Development, 35(1), 89–95. https://doi.org/10.1111/j.1365-2214.2008.00907.x
- Honomichl, R. D., Goodlin-Jones, B. L., Burnham, M., Gaylor, E., & Anders, T. F. (2002). Sleep patterns of children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 32(6), 553–561. https://doi.org/10.1023/a:1021254914276
- Horwood, L., Li, P., Mok, E., Shevell, M., & Constantin, E. (2019). A systematic review and meta-analysis of the prevalence of sleep problems in children with cerebral palsy: how do children with cerebral palsy difer from each other and from typically developing children? Sleep Health, 5(6), 555–571. https://doi.org/10.1016/j.sleh.2019.08.006
- Kerem, G. M., Mutlu, A., Livanelioglu, A., El, O., Baydar, M., Peker, O. et al. Turkish Expanded and Revised Gross Motor Function Classification System [Internet]. http://canchild- mgm.icreate3.esolutionsgroups.ca/en/GMFCS/resources/ GMFCS-ER.pdf.
- Khayatzadeh, M. M., Rostami, H. R., Amirsalari, S., & Karimloo, M. (2013). Investigation of quality of life in mothers of children with cerebral palsy in Iran: association with socio-economic status, marital satisfaction and fatigue. Disability and Rehabilitation, 35(10), 803–808. https://doi.org/10.3109/09638288.2012.708818
- Lang, C. P., Boucaut, A., Guppy, M., & Johnston, L. M. (2021). Children with cerebral palsy: A cross-sectional study of their sleep and their caregiver's sleep quality, psychological health and well-being. Child: Care, Health and Development, 47(6), 859–868. https://doi.org/10.1111/cch.12897
- Lee, J. (2013). Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: A literature review. Research in Developmental Disabilities, 34(11), 4255–4273. https://doi.org/10.1016/j.ridd.2013.09.008
- Manfredini, D., Restrepo, C., Diaz-Serrano, K., Winocur, E., & Lobbezoo, F. (2013). Prevalence of sleep bruxism in children: A systematic review of the literature. Journal of Oral Rehabilitation, 40(8), 631–642. https://doi.org/10.1111/joor.12069
- Mannion, A., & Leader, G. (2014). Sleep problems in autism spectrum disorder: A literatur review. Journal of Autism and Developmental Disorders, 1(Supp 2), 101-109. https://doi.org/ 10.1007/s40489-013-0009-y
- Matsuoka, M., Nagamitsu, S., Iwasaki, M., Iemura, A., Yamashita, Y., Maeda, M., et al. (2014). High incidence of sleep problems in children with developmental disorders: results of a questionnaire survey in a Japanese elementary school. Brain and Development, 36(1), 35–44. https://doi.org/10.1016/j.braindev.2012.12.004
- Mörelius, E., & Hemmingsson, H. (2014). Parents of children with physical disabilities - perceived health in parents related to the child's sleep problems and need for attention at night. Child: Care, Health and Development, 40(3), 412–418. https://doi.org/10.1111/cch.12079
- Newman, C. J., O'Regan, M., & Hensey, O. (2006). Sleep disorders in children with cerebral palsy. Developmental Medicine and Child Neurology, 48(7), 564–568. https://doi.org/10.1017/S0012162206001198
- Ortega, A. O., Guimarães, A. S., Ciamponi, A. L., & Marie, S. K. (2007). Frequency of parafunctional oral habits in patients with cerebral palsy. Journal of Oral Rehabilitation, 34(5), 323–328. https://doi.org/10.1111/j.1365-2842.2006.01703.x
- Owens, J. A., Spirito, A., & McGuinn, M. (2000). The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043–1051.
- Raina, P., O'Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., et al. (2005). The health and well-being of caregivers of children with cerebral palsy. Pediatrics, 115(6), e626–e636.https://doi.org/10.1542/peds.2004-1689.
- Rassafiani, M., Kahjoogh, M. A, Hosseini, & Sahaf, A. R. (2012). Time use in mothers of children with cerebral palsy: A comparison study. Hong Kong Journal of Occupational Therapy, 22(2): 70–74. https://doi.org/10.1016/j.hkjot.2012.11.001
- Restrepo, C., Manfredini, D., Castrillon, E., Svensson, P., Santamaria, A., Alvarez, C., et al. (2017). Diagnostic accuracy of the use of parental-reported sleep bruxism in a polysomnographic study in children. International Journal of Paediatric Dentistry, 27(5), 318–325. https://doi.org/10.1111/ipd.12262
- Richdale, A., & Wiggs, L. (2005). Behavioral approaches to the treatment of sleep problems in children with developmental disorders: What is the state of the art? International Journal of Behavioral Consultation and Therapy, 1(3), 165-190. http://dx.doi.org/10.1037/h0100743
- Romeo, D. M., Brogna, C., Quintiliani, M., Baranello, G., Pagliano, E., Casalino, T. et al. (2014). Sleep disorders in children with cerebral palsy: neurodevelopmental and behavioral correlates. Sleep Medicine, 15(2), 213–218. https://doi.org/10.1016/j.sleep.2013.08.793
- Romeo, D. M., Cioni, M., Distefano, A., Battaglia, L. R., Costanzo, L., Ricci, D. et al. (2010). Quality of life in parents of children with cerebral palsy: is it influenced by the child's behaviour? Neuropediatrics, 41(3), 121–126. https://doi.org/10.1055/s-0030-1262841
- Sarı, H.Y. (2010). Zihinsel yetersizliği olan çocuklarda uyku sorunları. Yeni Tıp Dergisi. 27 (3): 151-155.
- Takano, T., Hayashi, A., & Harada, Y. (2020). Progression of motor disability in cerebral palsy: the role of concomitant epilepsy. Seizure, 80, 81–85. https://doi.org/10.1016/j.seizure.2020.06.014
- Wayte, S., McCaughey, E., Holley, S., Annaz, D., & Hill, C. M. (2012). Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatrica, 101(6), 618–623. https://doi.org/10.1111/j.1651-2227.2012.02603.x
- Wright, M., Tancredi, A., Yundt, B., & Larin, H. (2006). Sleep issues in children with physical disabilities and their families. Physical & Occupational Therapy in Pediatrics, 26(3), 55–72. https://doi.org/10.1080/J006v26n03_05