The Impact of Sleep Disturbances on Health Related Quality of Life in Children with Acquired Brain Injury after Critical Care
Abstract
Background/Objective: Each year, more than 60,000 children with acquired brain injury (ABI) in the US require admission to the Pediatric Intensive Care Unit. Over 50% suffer sleep-wake disturbances (SWDs) in the months after hospital discharge. Given the importance of sleep to brain development and repair after injury, we hypothesized SWD would be associated with poorer health related quality of life (HRQOL) outcomes. Methods: We performed a cross-sectional analysis of prospectively collected data in children with ABI aged 3–18 years evaluated 1 to 3-months after critical care hospitalization (N=151). SWDs were measured by the Sleep Disturbances Scale for Children and defined as any T-score ≥60 signifying moderate or severe risk of clinical sleep disorders. Overall HRQOL was measured by the Pediatric Inventory for Quality of Life, which defines the Minimal Clinically Important Difference (MCID) as 4.5 points in the total score. Secondary outcomes included PedsQL scores for Physical, Emotional, Social, and School Function domains. SWD groups were compared with Mann Whitney tests. Multiple linear regression evaluated association between SWDs and overall HRQOL controlling for patient and ABI characteristics. Significance was defined as p<.05. Results: SWDs were present in 66% (n=100). HRQOL total score was significantly lower in children with SWDs (median=70; IQR=54, 80) versus without SWDs (median=85; IQR=67, 94; p<.001). Median scores in emotional, social, and school domains…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 60,000 participants or records.
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