Risk for Sleep-Disordered Breathing Among Children and Adolescents With Perinatal Stroke and the Impact on Mental Health, Quality of Life, and Caregivers.

BACKGROUND

Perinatal stroke is a leading cause of cerebral palsy and lifelong neurological disability and a potential risk factor for sleep-disordered breathing (SDB).

METHODS

We examined the risk for SDB and associated psychosocial outcomes among 77 children with perinatal stroke. Caregivers completed validated questionnaires evaluating their children's sleep (Pediatric Sleep Questionnaire), mental health (Behavior Assessment System for Children, Third Edition [BASC-3]), and quality of life (Pediatric Quality of Life Inventory [PedsQL]) as well as the psychosocial impact on themselves (Parental Outcome Measure [POM]).

RESULTS

The risk of SDB (SDB ratio of 0.33 or higher) in children with perinatal stroke was 34%. SDB symptomology was adversely associated with composite measures assessed by the BASC-3 including Externalizing and Internalizing Problems, Behavioral Symptoms Index, and Adaptability. SDB symptoms were associated with greater impairment in the following domains of the PedsQL: Daily Activities, Movement and Balance, Pain and Hurt, Fatigue, and Eating Activities. SDB symptomatology was also correlated with worse psychosocial impact and overall caregiver outcomes on the POM.

CONCLUSIONS

In conclusion, SDB symptoms are prevalent in children with perinatal stroke and may be associated with adverse psychosocial outcomes for children and caregivers. As a treatable modifier of long-term outcomes, increased awareness, screening, and study are required.