Do children living with a chronic disease have more disturbed sleep than their healthy peers?

Abstract

Study objectives: Living with a chronic disease (LCD) may impact sleep in children. We aimed to compare sleep in children LCD and healthy peers.

Methods: Design: Prospective study. Children and adolescents aged 6-17 years old answered the Sleep Screening Questionnaire Children and Adolescents (SSQ-CA) twice and wore actigraphy (AG) for seven nights and at-home polysomnography (PSG) for one night. Statistics: Unpaired two-sampled t-tests and correlation tests.

Results: We included 65 LCD and 63 healthy age-matched children. Compared to the healthy peers, the 6-12-year-olds LCD showed a clear tendency towards shorter total sleep time (TST): AG:16.1 min, [95% CI -0.3; 32.6], SSQ-CA: 19.9 min [-0.7-40.5], later chronotype and chronotype score: AG: 00:25, [-00:07; 00:57] and significantly longer objectively measured sleep latency (p=0.02). Except for a higher sleep and feeling safe subscale score, no major differences in either SSQ-CA or AG measures were seen between the adolescent groups (13-17-year-olds). In children with type 1 diabetes, inverse correlations between TST and glycated hemoglobin (HbA1c) (AG: r=-0.49, p=0.01; SSQ-CA: r=-0.40, p=0.01) were evident. Further, in children with tension-type headache, a strong inverse correlation between TST and monthly headache attacks (AG: r=-0.79, p=0.04) was also found.

Conclusions: Children LCD present more sleep disturbances than healthy peers, especially in the 6-12-year-olds. Sleep evaluation should be considered as part of the clinical evaluation.