Investigation of the Sleep Quality of Children Ages 4 to 6 Yr With Cerebral Palsy and Cerebral Visual Impairment and Their Caregivers’ Sleep Quality and Levels of Depression and Anxiety

Abstract

Importance:

Sleep disturbances are common in children with cerebral palsy (CP) and may worsen with cerebral visual impairment (CVI). Understanding CVI’s impact on children and caregiver mothers is essential for holistic care planning.

Objective:

To compare the sleep quality of children with CP with and without CVI and their caregiver mothers. Secondary objectives included comparing maternal anxiety and depression levels and examining associations between children’s visual function and both child and maternal well-being.

Design:

Cross-sectional comparative study conducted between November 2023 and April 2024.

Setting:

Special education and rehabilitation center.

Participants:

Eighty-four children ages 4 to 6 yr with CP (42 with CVI, 42 without CVI) and their primary caregiver mothers.

Outcomes and Measures:

Children’s sleep quality was assessed using the Child Sleep Habits Questionnaire (CSHQ) and visual functioning with the Visual Function Classification System (VFCS). Mothers’ sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), and their anxiety and depression was assessed with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI).

Results:

Children with CVI had significantly higher CSHQ scores (p < .05). Their mothers also reported significantly higher PSQI, BAI, and BDI scores (p < .05). VFCS score correlated with all child and maternal outcomes. Children’s sleep quality was the main predictor of maternal anxiety and depression (p < .05).

Conclusions and Relevance:

CVI in children with CP has been associated with poorer sleep in both children and caregivers, as well as higher psychological burden in caregivers. A strong relationship has been found between children’s sleep quality and mothers’ mental health.

Plain-Language Summary

This study found that children with cerebral palsy and cerebral visual impairment had poorer sleep quality, and their mothers exhibited lower sleep quality and higher levels of psychological distress. The children’s reduced visual functioning was found to be associated with poorer sleep quality and higher psychological distress. Children’s sleep quality emerged as the primary factor influencing maternal mental health. It is recommended that visual and sleep issues for children with cerebral palsy and cerebral visual impairment be addressed together in the rehabilitation process. Further studies are needed to translate these findings into clinical practice.

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