title: Effects of botulinum toxin serotype A on sleep problems in children with cerebral palsy and on mothers sleep quality and depression.
abstract: OBJECTIVE
  To evaluate botulinum toxin serotype A (BoNT-A) effects on sleep problems in children with cerebral palsy (CP) and on mothers` sleep quality and depression at multiple time points.
  
  
  METHODS
  This is a single center, cross sectional, and observational study was conducted to assess children with CP who were admitted. We recruited children with CP who were admitted to Ministry of Health Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey between September 2012 and April 2014 for the BoNT-A injection for lower limb spasticity. Sleep quality of children with CP were determined at baseline and at the first, third and sixth month after the BoNT-A injection. Sleep quality Pittsburgh Sleep Quality Index (PSQI) and depression (by Beck Depression Inventory-II Turkish version) in mothers were also assessed.
  
  
  RESULTS
  Twenty-four children with CP (7.05+/-2.69 years) underwent final assessment. Their bedtime resistance (11.71+/-3.26 versus (vs) 10+/-2.75, p<0.01), sleep anxiety (8.00+/-2.57 vs. 7.13+/-2.27, p=0.046) and daytime sleepiness (11.67+/-2.14 vs. 10.25+/-1.96, p<0.01) were significantly improved in the first month after the BoNT-A injection. In accordance with this, PSQI and BDI scores of the mothers decreased in the first month after the BoNT-A injection. Thereafter, BDI scores continued to decrease, whereas PSQI slightly increased in the third month.
  
  
  CONCLUSIONS
  The BoNT-A injection for spasticity in children with CP may have the potential to improve sleep quality in children with CP and their primary caregiver, the mother, as well as to reduce depression in the mother.
authors.affiliation: Ankara Physical Medicine Rehabilitation Training and Research Hospital, Ankara, Turkey. E-mail address: binayvildan@yahoo.com.
authors.forename: Vildan
authors.initials: V
authors.lastname: Binay Safer
authors.forename: Sibel
authors.initials: S
authors.lastname: Ozbudak Demir
authors.forename: Esma
authors.initials: E
authors.lastname: Ozkan
authors.forename: Fulya
authors.initials: F
authors.lastname: Demircioglu Guneri
mesh_terms: D000328:Adult; D001007:Anxiety; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology*; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A