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Interventions with a sleep outcome for children with cerebral palsy or a post-traumatic brain injury: a systematic review.

Sleep medicine reviews
December 1, 2012
Barbara C Galland et al. (3 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to review interventions for sleep problems in children with cerebral palsy (CP) or traumatic brain injury (TBI), including melatonin's effects.

Results Summary

Melatonin improved sleep latency and night waking in CP patients with phase or sleep maintenance disorders, with some showing increased total sleep time. No studies exclusively focused on CP or TBI patients using melatonin.

Population

Children aged 0-12 years with CP or TBI, and other medical conditions where sleep was measured.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (2)
InterventionDirectionEndpointPopulationDosageImpactClaim #
melatonin
decrease
sleep latency and night waking
CP patients with sleep problems/disorders
-
improvements in sleep latency and night waking were consistently found
#1
melatonin
increase
total sleep time
some subjects
-
improvements in total sleep time
#2
Abstract

The purpose of this study was to conduct a systematic literature review on interventions for sleep problems in children (aged 0-12 years) with cerebral palsy (CP) or traumatic brain injury (TBI). The literature describes sleep disorders as common in both conditions. Criteria were expanded to include interventions for other medical conditions where sleep was measured as an outcome. No interventions specifically designed to improve sleeping in children with CP or TBI were found. A literature search was conducted of five databases (Ovid MEDLINE, EMBASE, PsychINFO, CINAHL, and the Cochrane Database) from January 1 1990, to June 2011. The search terms [infant (age 0-23 months) or child, preschool (age 2-5 years) or child (age 6-12 years)] were used, with key terms related to CP and TBI. The search yielded 491 articles; 19 were relevant for CP, one for TBI. For CP, if the intervention improved the symptom/s targeted as primary outcome/s, sleep (measured as a secondary outcome) also improved. Few studies used objective measures of sleep, so efficacy could not be assessed. Only four studies were randomized controlled trials. Interventions were diverse. Where melatonin was used for CP patients with sleep problems/disorders, several related to phase or sleep maintenance disorders, improvements in sleep latency and night waking were consistently found, and in some subjects, improvements in total sleep time. No studies using melatonin studied CP patients exclusively. The one study where sleep was measured as a secondary outcome for TBI was of limited value. In conclusion, more well-designed studies are necessary to advance evidence-based treatments in the area of sleep problems for these chronic pediatric conditions.

Medical Subject Headings (MeSH)
Brain InjuriesCerebral PalsyChildChild, PreschoolHumansHypnotics and SedativesInfantMelatoninPostureSleep Apnea, ObstructiveSleep Wake Disorders
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality60/10
Citation Metrics
Total Citations28
Citations/Year2.2
Relative Citation Ratio1.37
NIH Percentile61.8%
Research Impact Scores
APT Score0.75
Weight Score1.24
Normalized Score0.60
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Interventions with a sleep outcome for children with cerebra... | Panacea Index