A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy

Study Objectives: Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy, we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals. Methods: We accrued the cohort between November 2019 and October 2020 and recruited children/youth who (1) were 8 -18 years old; (2) had cerebral palsy with any Gross Motor Function Classification System level; and (3) could self -report pain and sleep disturbance. We collected self -reported baseline and weekly follow-up data using electronic questionnaires completed every week for 5 weeks. Sleep disturbance at 5 weeks was the primary outcome (pediatric PatientReported Outcomes Measurement Information System short form, v1.0 -4a). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders. Results: A total of 190 individuals were eligible; 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% confidence interval, 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable, no/very mild pain, those in the stable, high -pain group had the greatest sleep disturbance (adjusted beta = 5.7; 95% confidence interval, 1.2, 10.2). Conclusions: Irrespective of pain trajectory, children and youth with cerebral palsy reported sleep disturbances. Those with a stable, high pain intensity in the previous 5 weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with cerebral palsy.