What keeps children with cystic fibrosis awake at night?

Abstract

Background: Sleep disturbance is common in children with cystic fibrosis (CF) however there are limited studies investigating the causes for poor sleep quality. In a cross sectional observational study we aimed to evaluate the clinical correlates of sleep disturbance in this population.

Methods: Children with CF (7-18years) free from pulmonary exacerbation completed medical review, overnight oximetry, the OSA-18 and 14days of actigraphy recordings with a sleep diary.

Results: In addition to FEV₁ <80% and low baseline SpO₂, CF-related diabetes, PEG feeding and co-morbid behaviour disorder were associated with lower objective sleep quantity. Paternal smoking and a family member with a mood disorder were also associated with sleep disturbance. The use of electronic devices before bedtime was associated with lower sleep quantity and quality. FEV₁, nocturnal cough, age and a behaviour disorder predicted sleep duration. FEV₁, nocturnal cough, SpO₂ nadir and asthma predicted sleep efficiency. Conversely, sleep efficiency independently predicted FEV₁.

Conclusions: Reduced sleep quality in children with CF is related to lung health and co-morbidities. However, family characteristics and poor sleep hygiene in the child were also associated with sleep disturbance. Optimal management of CF would seem to be the primary intervention to alleviate children's sleep disturbance, however our data raises additional targets for attempts to improve sleep.

Keywords: Actigraphy; Oximetry; Sleep; Sleep hygiene.