title: How Well Do Children with Cystic Fibrosis Sleep? An Actigraphic and Questionnaire-Based Study.
abstract: To measure sleep patterns and quality, objectively and subjectively, in clinically stable children with cystic fibrosis (CF) and healthy control children, and to examine the relationship between sleep quality and disease severity.
  
  
  
  Clinically stable children with CF and healthy control children (7-18 years of age) were recruited. Sleep patterns and quality were measured at home with actigraphy (14 days). Overnight peripheral capillary oxygen saturation was measured via the use of pulse oximetry. Daytime sleepiness was evaluated by the Pediatric Daytime Sleepiness Scale (PDSS) and subjective sleep quality by the Sleep Disturbance Scale for Children and Obstructive Sleep Apnea-18.
  
  
  
  A total of 87 children with CF and 55 control children were recruited with no differences in age or sex. Children with CF had significantly lower total sleep time and sleep efficiency than control children due to frequent awakenings and more wake after sleep onset. In children with CF, forced expiratory volume in 1 second and overnight peripheral capillary oxygen saturation nadir correlated positively with total sleep time and sleep efficiency and negatively with frequency of awakenings and wake after sleep onset. Patients with CF had significantly greater Sleep Disturbance Scale for Children (45 vs 35; P < .001), Obstructive Sleep Apnea-18 (35 vs 24; P < .001), and PDSS scores (14 vs 11; P < .001). There was a negative correlation between PDSS and forced expiratory volume in 1 second (r = -0.23; P < .05).
  
  
  
  Even in periods of clinical stability, children with CF get less sleep than their peers due to more time in wakefulness during the night rather than less time spent in bed. Objective measures of sleep disturbance and subjective daytime sleepiness were related to disease severity. In contrast, parents of children with CF report high levels of sleep disturbance unrelated to disease severity.
authors.affiliation: The Ritchie Centre, Department of Pediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Victoria, Australia; Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Moya
authors.initials: M
authors.lastname: Vandeleur
authors.affiliation: The Ritchie Centre, Department of Pediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Walter
authors.affiliation: The Ritchie Centre, Department of Pediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Victoria, Australia; Department of Sleep and Respiratory Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: David S
authors.initials: DS
authors.lastname: Armstrong
authors.affiliation: Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Robinson
authors.affiliation: The Ritchie Centre, Department of Pediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Victoria, Australia; Department of Sleep and Respiratory Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.affiliation: The Ritchie Centre, Department of Pediatrics, Monash University and Hudson Institute of Medical Research, Melbourne, Victoria, Australia. Electronic address: rosemary.horne@monash.edu.
authors.forename: Rosemary S C
authors.initials: RSC
authors.lastname: Horne
mesh_terms: D056044:Actigraphy / Q000379:methods; D000293:Adolescent; D017677:Age Distribution; D001315:Australia; D016022:Case-Control Studies; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D015994:Incidence; D008297:Male; D010092:Oximetry / Q000379:methods; D017286:Polysomnography / Q000379:methods; D011379:Prognosis; D011659:Pulmonary Gas Exchange; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
keywords: actigraphy; daytime sleepiness; sleep diaries