Assessments and interventions for sleep disorders in infants with or at high risk for cerebral palsy: A systematic review

Abstract 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.