Sleep quality and respiratory function in children with severe cerebral palsy using night-time postural equipment: a pilot study.
BACKGROUND
Night-time postural equipment (NTPE) prevents contractures and hip subluxation in children with severe physical disabilities. However, impact on sleep quality and respiratory function has not been objectively studied.


METHODS
Ten children with severe cerebral palsy (CP), mean age of 10.9 (range: 5.3-16.7) years, were recruited from a community population. Polysomnography was undertaken on two nights, once with the child sleeping in their NTPE and once sleeping unsupported. Randomization to first night condition controlled for first night effects.


RESULTS
Night-time postural equipment use was associated with higher mean overnight oxygen saturation for three children but lower values for six children compared with sleeping unsupported. There were no differences in sleep quality between the conditions. The study group had lower overnight oxyhaemoglobin saturation values, less rapid eye movement (REM) sleep and higher arousal indices compared with typically developing children.


CONCLUSIONS
This pilot study indicated that children with severe CP risk respiratory compromise in sleep irrespective of positioning. Further study will determine if the observed trend for mean overnight oxygen saturation to be lower within positioning equipment reflects random night-to-night variation or is related to equipment use. We suggest that respiratory function is assessed when determining optimal positioning for children using night-time positioning equipment.
Hill
Catherine M
CM
Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK. cmh2@southampton.ac.uk
Parker
Rachel C
RC
Allen
Penny
P
Paul
Annette
A
Padoa
Kathryn A
KA
D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy; D016009:Chi-Square Distribution; D002648:Child; D004864:Equipment and Supplies / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D017286:Polysomnography; D011187:Posture; D015656:Respiratory Mechanics / Q000502:physiology*; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D018709:Statistics, Nonparametric