Sleep Disturbances and Obstructive Sleep Apnea in Children and Adolescents with Cerebral Palsy: An Observational Study
Background/Objectives: Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standa...
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          | Published in | Neurology international Vol. 17; no. 7; p. 101 | 
|---|---|
| Main Authors | , , , , , , , | 
| Format | Journal Article | 
| Language | English | 
| Published | 
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        30.06.2025
     MDPI  | 
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| Online Access | Get full text | 
| ISSN | 2035-8377 2035-8385 2035-8377  | 
| DOI | 10.3390/neurolint17070101 | 
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| Abstract | Background/Objectives: Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standardized methods and limited access to appropriate diagnostic technologies and appropriate equipment. Thus, this study aimed to investigate the presence and severity of sleep disorders, with a particular focus on OSA, in children and adolescents with CP compared to their typically developing peers. Methods: This observational, clinical, and prospective study included 28 children and adolescents with CP and 32 age- and sex-matched typically developing individuals. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC) and a high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (Biologix® system), which provided data on oxygen saturation, snoring, movement during sleep, and total sleep time. Results: According to the SDSC, 92% of children and adolescents with CP presented scores indicative of sleep disturbances, compared to 31% of typically developing individuals. SDB was the most prevalent subtype (64%) and overnight oximetry revealed that 100% of the CP group presented oxygen desaturation index (ODI) values consistent with a diagnosis of OSA. The CP group also exhibited significantly lower mean SpO2, longer snoring duration, shorter total sleep time, and prolonged sleep latency compared to the typically developing group. Conclusions: Children and adolescents with cerebral palsy (CP) exhibit a high prevalence of sleep disturbances, with increasing evidence indicating a significant occurrence of sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA). | 
    
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| AbstractList | Background/Objectives: Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standardized methods and limited access to appropriate diagnostic technologies and appropriate equipment. Thus, this study aimed to investigate the presence and severity of sleep disorders, with a particular focus on OSA, in children and adolescents with CP compared to their typically developing peers. Methods: This observational, clinical, and prospective study included 28 children and adolescents with CP and 32 age- and sex-matched typically developing individuals. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC) and a high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (Biologix® system), which provided data on oxygen saturation, snoring, movement during sleep, and total sleep time. Results: According to the SDSC, 92% of children and adolescents with CP presented scores indicative of sleep disturbances, compared to 31% of typically developing individuals. SDB was the most prevalent subtype (64%) and overnight oximetry revealed that 100% of the CP group presented oxygen desaturation index (ODI) values consistent with a diagnosis of OSA. The CP group also exhibited significantly lower mean SpO2, longer snoring duration, shorter total sleep time, and prolonged sleep latency compared to the typically developing group. Conclusions: Children and adolescents with cerebral palsy (CP) exhibit a high prevalence of sleep disturbances, with increasing evidence indicating a significant occurrence of sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA). Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standardized methods and limited access to appropriate diagnostic technologies and appropriate equipment. Thus, this study aimed to investigate the presence and severity of sleep disorders, with a particular focus on OSA, in children and adolescents with CP compared to their typically developing peers. This observational, clinical, and prospective study included 28 children and adolescents with CP and 32 age- and sex-matched typically developing individuals. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC) and a high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (Biologix system), which provided data on oxygen saturation, snoring, movement during sleep, and total sleep time. According to the SDSC, 92% of children and adolescents with CP presented scores indicative of sleep disturbances, compared to 31% of typically developing individuals. SDB was the most prevalent subtype (64%) and overnight oximetry revealed that 100% of the CP group presented oxygen desaturation index (ODI) values consistent with a diagnosis of OSA. The CP group also exhibited significantly lower mean SpO , longer snoring duration, shorter total sleep time, and prolonged sleep latency compared to the typically developing group. Children and adolescents with cerebral palsy (CP) exhibit a high prevalence of sleep disturbances, with increasing evidence indicating a significant occurrence of sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA). Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standardized methods and limited access to appropriate diagnostic technologies and appropriate equipment. Thus, this study aimed to investigate the presence and severity of sleep disorders, with a particular focus on OSA, in children and adolescents with CP compared to their typically developing peers.BACKGROUND/OBJECTIVESCerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to an increased risk of obstructive sleep apnea (OSA). OSA is underdiagnosed in this population due to the lack of standardized methods and limited access to appropriate diagnostic technologies and appropriate equipment. Thus, this study aimed to investigate the presence and severity of sleep disorders, with a particular focus on OSA, in children and adolescents with CP compared to their typically developing peers.This observational, clinical, and prospective study included 28 children and adolescents with CP and 32 age- and sex-matched typically developing individuals. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC) and a high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (Biologix® system), which provided data on oxygen saturation, snoring, movement during sleep, and total sleep time.METHODSThis observational, clinical, and prospective study included 28 children and adolescents with CP and 32 age- and sex-matched typically developing individuals. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC) and a high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (Biologix® system), which provided data on oxygen saturation, snoring, movement during sleep, and total sleep time.According to the SDSC, 92% of children and adolescents with CP presented scores indicative of sleep disturbances, compared to 31% of typically developing individuals. SDB was the most prevalent subtype (64%) and overnight oximetry revealed that 100% of the CP group presented oxygen desaturation index (ODI) values consistent with a diagnosis of OSA. The CP group also exhibited significantly lower mean SpO2, longer snoring duration, shorter total sleep time, and prolonged sleep latency compared to the typically developing group.RESULTSAccording to the SDSC, 92% of children and adolescents with CP presented scores indicative of sleep disturbances, compared to 31% of typically developing individuals. SDB was the most prevalent subtype (64%) and overnight oximetry revealed that 100% of the CP group presented oxygen desaturation index (ODI) values consistent with a diagnosis of OSA. The CP group also exhibited significantly lower mean SpO2, longer snoring duration, shorter total sleep time, and prolonged sleep latency compared to the typically developing group.Children and adolescents with cerebral palsy (CP) exhibit a high prevalence of sleep disturbances, with increasing evidence indicating a significant occurrence of sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA).CONCLUSIONSChildren and adolescents with cerebral palsy (CP) exhibit a high prevalence of sleep disturbances, with increasing evidence indicating a significant occurrence of sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA).  | 
    
| Author | Pinato, Luciana Marques, Ana Elisa Zuliani Stroppa da Silveira Cruz-Machado, Sanseray de Andrade, Leticia Monteiro Meneses da Silva, Isabella do Couto, Maria Clara Helena Pedroni, Cristiane Rodrigues Giacheti, Celia Maria  | 
    
| AuthorAffiliation | 2 Graduate Program in Health Sciences and Human Communication, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil; clara.couto@unesp.br (M.C.H.d.C.); sanseray@hotmail.com (S.d.S.C.-M.); c.giacheti@unesp.br (C.M.G.); cristiane.pedroni@unesp.br (C.R.P.) 1 Undergraduate Program in Speech, Language and Hearing Sciences, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil; isabella.meneses@unesp.br (I.M.d.S.); lm.andrade@unesp.br (L.M.d.A.) 4 Department of Speech, Language and Hearing Sciences, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil 3 Department of Physiotherapy and Occupational Therapy, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil; ana.stroppa@unesp.br  | 
    
| AuthorAffiliation_xml | – name: 2 Graduate Program in Health Sciences and Human Communication, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil; clara.couto@unesp.br (M.C.H.d.C.); sanseray@hotmail.com (S.d.S.C.-M.); c.giacheti@unesp.br (C.M.G.); cristiane.pedroni@unesp.br (C.R.P.) – name: 1 Undergraduate Program in Speech, Language and Hearing Sciences, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil; isabella.meneses@unesp.br (I.M.d.S.); lm.andrade@unesp.br (L.M.d.A.) – name: 3 Department of Physiotherapy and Occupational Therapy, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil; ana.stroppa@unesp.br – name: 4 Department of Speech, Language and Hearing Sciences, Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Campus Marilia 17525-900, Brazil  | 
    
| Author_xml | – sequence: 1 givenname: Isabella surname: Meneses da Silva fullname: Meneses da Silva, Isabella – sequence: 2 givenname: Maria Clara Helena surname: do Couto fullname: do Couto, Maria Clara Helena – sequence: 3 givenname: Sanseray orcidid: 0000-0002-6937-7207 surname: da Silveira Cruz-Machado fullname: da Silveira Cruz-Machado, Sanseray – sequence: 4 givenname: Leticia Monteiro surname: de Andrade fullname: de Andrade, Leticia Monteiro – sequence: 5 givenname: Ana Elisa Zuliani Stroppa surname: Marques fullname: Marques, Ana Elisa Zuliani Stroppa – sequence: 6 givenname: Celia Maria surname: Giacheti fullname: Giacheti, Celia Maria – sequence: 7 givenname: Cristiane Rodrigues surname: Pedroni fullname: Pedroni, Cristiane Rodrigues – sequence: 8 givenname: Luciana surname: Pinato fullname: Pinato, Luciana  | 
    
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| Snippet | Background/Objectives: Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB),... Cerebral palsy (CP) is a neurodevelopmental disorder associated with sleep disturbances, particularly sleep-disordered breathing (SDB), and is often linked to...  | 
    
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| SubjectTerms | Airway management Behavior disorders Cerebral palsy children Children & youth Classification Melatonin Observational studies oximetry Pediatrics Quality of life Sleep apnea sleep apnea syndromes Sleep disorders Teenagers  | 
    
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| Title | Sleep Disturbances and Obstructive Sleep Apnea in Children and Adolescents with Cerebral Palsy: An Observational Study | 
    
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