title: Sleep disturbances in children with multiple disabilities.
abstract: BACKGROUND
  Although sleep disturbances in disabled children are of central clinical importance, there is little research on that topic. There are no data available on frequency, severity or aetiology of sleep disturbances and related symptoms in this specific patient group.
  
  
  OBJECTIVE
  To review the current state of research and outline future research objectives.
  
  
  METHODS
  We searched international scientific databases for relevant publications from 1980-2009. From all papers qualifying for further analysis we retrieved systematic information on sample characteristics, sleep assessment tools and their test quality criteria, and core findings.
  
  
  RESULTS
  61 publications including 4392 patients were categorized as "mixed" (reporting on heterogeneous diagnoses), or "specified" papers (specific diagnoses) based on international classification of diseases (ICD) 10 classification. To assess sleep disturbances, most authors relied on subjective instruments with poor psychometric quality. Mean prevalence of sleep disturbances was 67% (76%,"mixed" group; 65%, "specified" group). In children suffering severe global cerebral injury, the prevalence of sleep disturbances was even higher (>90%). The most frequent symptoms were insomnia and sleep-related respiratory disorders. Some of these symptoms were closely associated with specific medical syndromes.
  
  
  CONCLUSIONS
  There is an urgent need for sleep disturbance assessment tools evaluated for the patient group of interest. By use of validated assessment tools, patient factors, which may be crucial in causing sleep disturbances, may be investigated and appropriate treatment strategies may be developed.
authors.affiliation: Vodafone Foundation Institute and Chair for Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Children's Hospital Datteln, 45711 Datteln, Germany. a.tietze@kinderklinik-datteln.de
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Tietze
authors.forename: Markus
authors.initials: M
authors.lastname: Blankenburg
authors.forename: Tanja
authors.initials: T
authors.lastname: Hechler
authors.forename: Erik
authors.initials: E
authors.lastname: Michel
authors.forename: Michelle
authors.initials: M
authors.lastname: Koh
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schlüter
authors.forename: Boris
authors.initials: B
authors.lastname: Zernikow
mesh_terms: D000293:Adolescent; D002648:Child; D019988:Children with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy