Providing the Best Sleep Bedroom Environment for Children with Cerebral Palsy

Abstract

Sleep is an active process, essential for physical, emotional and cognitive development of children. Between 23-46% of children with cerebral palsy (CP) have sleep problems. Often sleep problems go undiagnosed and undertreated in spite of the serious impact of sleep deficiency on children’s health and development. Interventions, if they are offered, are most often pharmacological. However medication side effects are a significant concern and the evidencebase is lacking. There is a need for effective non-pharmacological intervention to address sleep problems. Objectives: 1) To determine if providing parents with sleep education and problem solving strategies, in the form of a manual, increases parental knowledge. 2) To determine if increases in knowledge then translate to parents taking actions to address features in the bedroom that negatively affect sleep. Methods: This pilot study used a single-case series design. Recruitment of child/parent participants was through community partners. Baseline and 6 week follow-up data collection included the Parental Sleep Environment Knowledge Questionnaire (PSEKQ), Parental Interactive Bedtime Behavior Scale, Child Sleep Habit Questionnaire, Parent Knowledge of Healthy Sleep and objective sleep actigraphy. Parents received the Children’s Best Bedroom for Sleep (CBBES) manual (including basic sleep science information, a self-assessment tool, and ii environmental modification recommendations) as the intervention post-baseline. Descriptive statistics were used for analysis. Results: There were 6 parent/child participants. As expected, minimal change was demonstrated in parents sleep behavioural measures. Scores on the Parent Sleep Environment Knowledge Questionnaire (PSEKQ) improved slightly (66.66% at baseline to 78.33% at follow-up). Also, the post-intervention results using the bedroom environment assessment checklist provided in the CBBES manual demonstrated improved parent ability to assess their child’s bedroom and act to correct problems. Conclusion: Results support that providing parents with a sleep environment psycho-education manual to build knowledge and skills for addressing environmental components of their child’s sleep problems. This research is innovative and will benefit not only children with cerebral palsy and their parents but may also apply to children with other health conditions.