Prevalence and factors associated with sleep disorders among children with cerebral palsy in Uganda; a cross-sectional study

BACKGROUND: Sleep plays a prominent role in the growth and development of children. Children with cerebral palsy (CP) are more prone to sleep disorders (SDs) than their peers. Children with CP, have a higher prevalence of disorders involving; initiation and maintenance of sleep, sleep-wake transition, excessive sleepiness and arousal. These sleep disorders impact on the quality of life of these children. Despite, having a high prevalence of CP in Uganda, there is a paucity of data that focuses on sleep disorders in CP, including a lack of prevalence estimates of sleep breathing disorder (SBD) in CP. Understanding the prevalence and disorders of sleep within this population would help advise on the development of tailored interventions to address the needs of these children and improve their quality of life. This study determined the prevalence and associated factors of sleep disorders among children aged 2 – 12 years with cerebral palsy in Uganda. METHODS: This was a cross sectional study. All participants had a physical examination and screening with the Sleep Disturbances Scale for Children (SDSC) questionnaire to determine the prevalence of sleeps disorders. A total score (TS) ≥ 51 on the Sleep Disturbances Scale for Children was regarded as abnormal. RESULTS: A total of 135 participants were recruited. The prevalence of sleep disorders was 43/135 (32%) with 95% CI: (24.0-39.7). The most common type of sleep disorders was a disorder of initiating and maintaining sleep 37(27%). The factors associated with sleep disorders among children with cerebral palsy were bilateral spasticity (p = 0.004); OR:(95%CI), 11.193: (2.1 – 59.0), lowest levels of gross motor function V (p = < 0.001); OR:(95%CI), 13.182: (3.7 – 47.0) or IV (p = 0.007); OR:(95%CI), 12.921: (2.0 – 82.3), lowest level of manual ability V (p = 0.004); OR:(95%CI), 11.162: (2.2 – 56.4) and presence of epilepsy (p = 0.011); OR:(95%CI), 3.865: (1.4 – 10.9). CONCLUSIONS: The prevalence of sleep disorders among children with cerebral palsy in Uganda is high. Severe disability and presence of epilepsy were associated with sleep disorders among children with cerebral palsy.