An observational study of sleep in childhood post-neonatal encephalopathy

Abstract

Aim: Neonatal encephalopathy (NE) is associated with altered cognitive, motor, sensory abilities and behavioural outcomes. This case-control study aimed to assess whether Quality of Life (QoL) and sleep disorders are affected in older children following NE compared to age-matched controls.

Methods: Children at school-age post-NE were recruited and compared to age-matched controls. Sleep and QoL were assessed with the Pediatric Quality of Life Inventory and the Child Sleep Habit Questionnaire.

Results: One hundred children were recruited with an age range of 4-6 years, including children post-NE (n=45) and age-matched controls (n = 55). Significantly higher pathological sleep scores were evident in 58% of children post-NE compared to controls (43.8 vs 40.2; p = 0.001). Children post-NE had increased bedtime resistance (p = 0.028) and sleep anxiety (p = 0.01) compared to controls. Children in the post-NE group had lower total QoL scores versus controls (mean score 82.5 vs 95.8; p < 0.01). Children with mild NE also had lower total QoL scores than controls (90.0 vs 95.8, p = 0.003). There was a strong correlation between low QoL with high total sleep scores (Rho 0.339, p = 0.014).

Conclusion: There were high rates of sleep issues in school-aged children with mild and moderate-severe NE. Consideration and management of sleep problems may improve QoL in childhood post-NE.

Keywords: Neonatal Encephalopathy; hypoxic-ischaemic encephalopathy; quality of life; sleep.