The Prevalence and Characteristic of Sleep Problems among Children with Fetal Alcohol Spectrum Disorders (FASD).

Abstract

BackgroundFetal alcohol spectrum disorders (FASD) is a group of conditions resulting from prenatal alcohol exposure (PAE). Patients with FASD experience a variety of neuropsychological symptoms resulting from central nervous system impairment. Little is known about sleep disorders associated with PAE. The objective of this study was to investigate the prevalence and characterize sleep problems among individuals with FASD.Methods40 patients from FASD diagnostic center (median age 8 years (6; 11)) diagnosed with one of the FASD diagnosis and 40 patients from the control group (median age 10 years (8; 13)) participated in the study. In the 1st phase, the screening of sleep problems was performed with Child Sleep Habit Questionnaire (CSHQ) filled in by a caregiver. Those who scored above 41 points were qualified to the 2nd phase of the study in which in-lab attended polysomnography (PSG) was performed. The measurements consisted of electroencephalographic channels, left and right electrooculograms, chin electromyogram, left and right tibialis electromyogram, electrocardiogram, ventilatory monitoring, breathing effort, pulse oximetry, snoring and body position.ResultsThe number of participants with sleep disturbances was markedly higher in the study group as compared to controls (55% vs. 20%). The age-adjusted odds ratio for a positive result in CSHQ was 4.31 (95% CI: 1.54-12.11; p=0.005) for FASD patients as compared to the control group. Significant differences between the study and control groups were observed in the following subscales: sleep onset delay, night wakings , parasomnias , sleep disordered breathing, and daytime sleepiness. In PSG children from the FASD group and children from the control group experienced more arousals during the sleep than the children from the laboratory control group. ). There were no significant differences in comparison of respiratory indexes between FASD and control groups although indices in both groups were higher than previously published data for a normal population.ConclusionSleep disorders are more common among individuals with FASD than among healthy children. As distorted sleep can affect daily performance and worsen neurodevelopmental issues, it is vital for the pediatricians and other FASD specialists to include the question about sleep in the anamnesis.