Parent-reported symptoms and screening risk of sleep disordered breathing in Australian children with neurodisability: a cross-sectional study.

PURPOSE: In children with neurodisability (ND) sleep problems are common and often multifaceted with complex aetiology. Few studies have evaluated the prevalence of sleep disordered breathing (SDB) in a broad population of children with ND. This study aims to evaluate the parent-reported prevalence of SDB in children with ND. METHODS: As part of a multi-site, cross-sectional survey, caregivers of community-based and hospital-referred children with ND aged 2-18 years completed the pediatric sleep questionnaire (PSQ). The PSQ was scored according to validated methods, including snoring, sleepiness, and behavioural subscales. RESULTS: A total of 216 eligible participants with complete PSQ responses were included (56.2% male, 53.6% age 5-12yrs). 36.7% had a developmental disorder, 35% a genetic syndrome, 15.9% neurological disorders, and 12.4% other ND. The majority of children (75.2%) had parent-reported positive PSQ (PSQ>0.33; mean PSQ 0.46 ± 0.18). Participants scored most highly in behavioural symptoms (83.3, IQR 50.0-100.0), and least highly in snoring symptoms (23.7, IQR 0.0-25.0). Positive PSQ prevalence differed significantly by age, with a maximal prevalence in the 5-12yrs group. There were no significant differences in parent-reported prevalence of SDB between disability categories, recruitment site or those who had undergone adenotonsillar surgery. CONCLUSION: This study is the first to report on the prevalence of parent-reported symptoms of sleep problems in a large cohort of Australian children with ND. While SDB was not confirmed by diagnostic polysomnography, this study demonstrates a high pretest probability of behavioural issues and SDB, with 3 in 4 participants having a positive PSQ result. These findings highlight the importance of screening for SDB in children with ND to ensure early intervention.