Sleep Assessments for Children With Severe Cerebral Palsy: A Scoping Review

Objectives: To identify the sleep-based instruments in postural care intervention research and examine whether the instruments are suitable as postural care outcome measures specifically for children with severe cerebral palsy. Data Sources: Investigators searched the electronic databases from 2 university library systems, including OVID Medline, CINAHL, OT Search, Cochrane Database of Systematic Reviews, and Health and Psychosocial Instruments for articles published between 2000 and October 2019. Study Selection: The initial search yielded 1928 abstracts. Two independent investigators identified 8 English-language peer-reviewed articles that published postural care intervention study results. Data Extraction: Investigators screened the 8 articles and found that 6 included sleep as a primary or secondary intervention outcome. The principal investigator then fully reviewed these 6 publications, recorded their sleep-related instruments, and applied Coster's published guidelines (2013) to analyze the sleep-based instruments' suitability as outcome measures. Data Synthesis: Collectively, the 6 studies used 8 distinct measures, 6 of which (actigraphy, Chailey Sleep Questionnaire, Pediatric Sleep Questionnaire, polysomnography, sleep diary, and Sleep Disturbance Scale for Children) underwent analysis. As stand-alone instruments, none completely met criteria for suitability as outcome measures for those with severe cerebral palsy. Conclusions: Combined use of the Sleep Disturbance Scale for Children and actigraphy may be favorable for assessing the sleep-related domains relevant to children with severe cerebral palsy. However, rehabilitation professionals should test sensitivity and specificity to understand the instruments’ ability for capturing changes in sleep from postural care intervention.