Sleep Problems in Children with Fetal Alcohol Spectrum Disorders
1Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine, Seattle, WA; 2Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry, University of Washington School of Medicine, Seattle Children's Hospital Research Institute, Seattle, WA; 3Seattle Children's Hospital Research Institute, Center on Child Health, Development and Behavior, Seattle, WA; 4The Forsyth Institute, Cambridge, Massachusetts and University of Washington School of Public Health, Seattle, WA; 5Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC
Sleep problems in children with fetal alcohol spectrum disorders (FASD) are reportedly common but not well characterized. Objectives were to: (1) assess sleep concerns in children with FASD using a caregiver-report survey, the Children's Sleep Habits Questionnaire (CSHQ); (2) compare CSHQ results with those of previously reported community sample; and (3) describe pilot polysomnography findings in children with FASD.
Children with FASD were recruited from a behavioral intervention study, and participating caregivers completed the CSHQ. CSHQ results were compared with the original data from a previously published community sample of similar age. Participants with FASD and elevated CSHQ scores were offered overnight polysomnography.
Thirty-three children with FASD (4.1-12.1 years) were enrolled; 85% of children with FASD scored above the clinical cutoff Total Score of 41, reflecting marked sleep disturbance. Elevated subdomain scores occurred primarily in areas concerning for pediatric insomnia. Those with comorbid ADHD had elevated CSHQ on additional subdomains with no difference in Total Scores. Compared with the community sample, children with FASD had higher Total Scores on the CSHQ (52 vs. 39, p < 0.001). Polysomnography, completed in 5 subjects, revealed mild sleep disordered breathing and fragmented sleep with elevated non-respiratory arousal indices.
Clinically significant sleep problems are present in children with FASD on both subjective and objective measures. Further investigation is needed to better describe these sleep disturbances and their impact on overall health and daytime neurobehavioral problems in this clinical population.
Chen ML; Olson HC; Picciano JF; Starr JR; Owens J. Sleep problems in children with fetal alcohol spectrum disorders. J Clin Sleep Med 2012;8(4):421-429.
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