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Comparison of rate of sleep disorders and patterns in children with neurodevelopmental disorders with neurologically normal children

Aheed Khan*, LN Taneja, Jyoti Bhatia

Introduction: Changing sleep patterns in children attributing to changing lifestyles and increased screen time had led to more pronounced cognitive, emotional, social and behavioural problems in children. In the Indian setup, parents are seen to be less aware of the impact of sleep during the early growing years as well as during school going age. Children suffering from psychiatric or neurodevelopmental problems are also exposed to increased sleep related problems and can augment symptoms and caregiver burden. There is paucity of research rigor in sleep problems in various neurodevelopmental disorders, especially in the Indian subtext.

Objectives: We aimed to find if there are significant sleep problems in children with neurodevelopmental disorders as compared to neurologically normal children of consecutive age in a tertiary care hospital in Delhi, India. We also intend to compare and contrast sleep disorder trends in these children.

Methods: 98 children with newly diagnosed neurodevelopmental disorder or old follow-ups were taken from the OPD/IPD of a tertiary care hospital in Delhi with consecutive 98 ages matched controls. Parents of these children were interviewed using the Sleep Disturbance Scale in Children (SDSC) and sleep scores were calculated.

Results: Student T-test and Chi-square was used for data analysis and it was reported that 73 (74.5%) children out of the 98 children recruited had profound sleep problems according to the SDSC scale and only 12 (12.2%) children out of the 98 recruited from the control group had reported sleep problems. This difference was found statistically significant (p<0.001). In our test sample, 29 children had autism spectrum disorder, 17 had Attention Deficit Hyperactivity Disorder (ADHD), 22 had cerebral palsy, 16 had global developmental delay and 14 had intellectual disability. Out of these ADHD had the maximum positive sleep score (88.2%) followed by cerebral palsy (86.3%) while the lowest was for global developmental delay (56.25%). We also found that 69 children out these 73, with a positive sleep score, were affected with disorder of initiating and maintaining sleep; which was followed by sleep wake transition disorder while the lowest number is for Sleep hyperhidrosis.

Conclusion: It is concluded that children suffering with any neurodevelopmental disorder had significantly more sleep problems than neurologically normal children. Amongst the various sleep problems in children and adolescence, we also reported that disorder of initiation and maintaining sleep leading to insomnia in these children is the most commonly observed sleep problem followed by sleep wake transition disorder. The least common sleep disorder was found to be sleep hyperhidrosis. Autism spectrum disorder, cerebral palsy and Attention Deficit Hyperactivity Disorder (ADHD) were found to be having maximum attendance, while children affected with ADHD and cerebral palsy were most gravely affected by sleep related problems.