Background

Children with cerebral palsy (CP) are five times more likely than typically developing children to have sleep problems, resulting in adverse outcomes for both children and their families. The purpose of this systematic review was to gather current evidence regarding assessments and interventions for sleep in children under age two with or at high risk for CP and integrate these findings with parent preferences.

Methods

Five databases (CINAHL, EMBASE, OVID/Medline, SCOPUS, and PsycINFO) were searched. Included articles were screened using PRISMA guidelines and quality of the evidence was reviewed using best-evidence tools by two independent reviewers at minimum. An online survey was conducted regarding parent preferences through social media channels.

Results

Eleven articles met inclusion criteria. Polysomnography emerged as the only high-quality assessment for the population. Three interventions (medical cannabis, surgical interventions, and auditory, tactile, visual, and vestibular stimulations) were identified; however, each only had one study of effectiveness. The quality of evidence for polysomnography was moderate, while the quality and quantity of the evidence regarding interventions was low. Survey respondents indicated that sleep assessments and interventions are highly valued, with caregiver-provided interventions ranked as the most preferable.

Conclusions

Further validation research is needed of affordable and feasible sleep assessments compared to polysomnography the reference standard. In the absence of diagnostic-specific evidence of safety and efficacy of sleep interventions specific to young children with CP, it is conditionally recommended that clinicians follow guidelines for safe sleep interventions for typically developing children.

中文翻译：

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脑瘫或脑瘫高危婴儿睡眠障碍的评估和干预：系统评价

背景

患有脑瘫 (CP) 的儿童出现睡眠问题的可能性是正常发育儿童的五倍，从而对儿童及其家庭造成不利影响。本系统评价的目的是收集有关 CP 或高危 2 岁以下儿童睡眠评估和干预的当前证据，并将这些发现与父母的偏好相结合。

方法

搜索了五个数据库（CINAHL、EMBASE、OVID/Medline、SCOPUS 和 PsycINFO）。纳入的文章使用 PRISMA 指南进行筛选，证据质量至少由两名独立评审员使用最佳证据工具进行评审。通过社交媒体渠道对家长的偏好进行了在线调查。

结果

11 篇文章符合纳入标准。多导睡眠图成为对人群唯一的高质量评估。确定了三种干预措施（医用大麻、手术干预以及听觉、触觉、视觉和前庭刺激）；然而，每个人都只有一项有效性研究。多导睡眠图的证据质量中等，而干预措施的证据质量和数量都很低。调查受访者表示，睡眠评估和干预措施受到高度重视，护理人员提供的干预措施被列为最可取的。

结论

与参考标准多导睡眠图相比，需要进一步的验证研究来进行负担得起且可行的睡眠评估。在缺乏针对患有 CP 的幼儿睡眠干预的安全性和有效性的诊断特异性证据的情况下，有条件地建议临床医生遵循针对正常发育儿童的安全睡眠干预指南。