How Well Do Children with Cystic Fibrosis Sleep? An Actigraphic and Questionnaire-Based Study

Lead researcher

Moya Vandeleur

Main finding

Our study has shown that even in periods of clinical stability, children with Cystic Fibrosis (CF) have less sleep than their healthy peers, due to more time in wakefulness during the night rather than less time spent in bed. High reported levels of subjective sleep disturbance were not related to markers of disease severity, whereas objective measures of sleep disturbance and subjective daytime sleepiness were related to disease severity. These findings highlight the importance of including sleep in the rationale for optimizing lung disease in children with CF. Further studies are needed however to better understand the non-respiratory co-morbidities associated with sleep disturbance in children with CF, as these too may be modifiable.

Centre

The Ritchie Centre

Research group

Paediatric Sleep

Co-authors

Dr Moya Vandeleur , Dr Lisa Walter, A/Prof David Armstrong, A/Prof Phil Robinson, A/Prof Gillian Nixon, Prof Rosemary Horne.

Journal and article title

Most surprising

To our knowledge this is the first study that reports objectively measured sleep patterns in children with Cystic Fibrosis (CF) in the real life home environment, including capturing the weekdays and weekends with analysis of sleep schedule variability. Consistent with our hypothesis, we showed that clinically stable children aged 7-18 years with CF have reduced total sleep time when compared to healthy control children by 30 minutes. Reduced sleep time was not however due to later bedtimes or a more variable sleep schedule as predicted, but due to more frequent nightly awakenings. Objective sleep quality, indicated by frequency of awakenings, wake after sleep onset and movement fragmentation index, was related to severity of lung disease . However, parents of children with CF reported more sleep symptoms which were not explained by the severity of the child’s lung disease. Finally, children with CF experienced significantly more daytime sleepiness than healthy controls with almost half reporting symptom scores in the clinically significant range.

Future implications

Our findings highlight the importance of including sleep in the rationale for optimising lung disease, and improving daytime school performance and quality of life in children with CF.

Disease/health impact

Cystic Fibrosis