الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cerebral palsy (cp) is nowadays following eradication of poliomyelitis considered to be the most common cause of physical disability among children worldwide. Incidence is about 2 per 1000 live birth. In addition to movement or posture, children with CP may have a range of associated disabilities, including intellectual disability, hearing and visual deficits, nutritional and feeding problems, respiratory infections and epilepsy. CP is due to abnormal development or damage occurring to the developing brain.
It has been estimated that about 80% of children with CP have some type of movement disorder. CP is most often classified as either spastic, dyskinetic, or ataxic. Although spasticity is often the dominant disorder, many children with CP have mixed spasticity and dystonia. The traditional classifications of limb distribution for the hypertonic (primarily spastic) form of CP: hemiplegia, diplegia, and quadriplegia/tetraplegia (and occasionally triplegia), continue to be used clinically. It can be also classified based on GMFCS, which uses a five-level system that corresponds to the extent of ability and impairment limitation. A higher number indicates a higher degree of severity.
The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behaviors, by epilepsy, and by secondary musculoskeletal problems.
About 20-42 % of CP children suffer from sleep problems. Sleep deficiency in children increases the risk of negative mood, behavioral problems, cognitive impairments, emotional problems, and poor school performance and health problems.
Sleep deficiency (SD) in children with underlying neurodevelopmental disabilities is more difficult to identify and address than in typically developing children.
CP children have multiple risk factors for SD because of the nature of their primary brain injury and resultant morbidity.
Sleep promotes healthy neuropsychological function and learning in childhood. Conversely, sleep disturbance is associated with challenging behaviour in learning disabled children
The aim of the present study was to: study the sleep problems in children with CP.
A cross sectional case control study was carried out on a group of 50 children with CP attending the neurology clinic in AUCH. A fifty age and sex matched apparently healthy children included in the study as a control group.
A pre designed structured interview questionnaire was used to collect the data required from the mothers.
Assessment of sleep problems was assessed using the CSHQ.
The SPSS 16.0 statistical packages was used for data entry and analysis :
• Age ranged between 4.0-12.0 for both groups with the mean of 7.60+_ 2.466 and 7.86 +_ 1.969 for cases and control groups respectively.
• They included 33 (66,0 %) and 22 (44.0%) boys and 17 (34.0%) and 28 (56.0%) girls for cases and control groups respectively.
• The cases were 42 spastic, 3 dyskinetic and 5 mixed type of CP.
• The spastic cases were 15 diplegia, 14 hemiplegia, 9 tetraplegia and 4 triplegia topographically.
• There were 20 cases in level I GMFCS, 14 in level II, 6 in level III, 1 in level IV, 9 in level V.
• Score for bedtime resistance ranged between 10-14 and 10-15 with the mean of 12.44+_1,487 and 12.80+_ 1.429 for control and cases groups respectively with no statistical significant difference between the two groups.
• Score for sleep duration ranged between 5-6 and 4-9 with the mean of 5.48+_0,505 and 5.87+_ 1.200 for controls and cases groups respectively with no statistical significant difference between the two groups.
• Score for sleep onset delay ranged between 1-2 and 1-3 with the mean of 1.4+_,495 and 1.92+_ 0.778 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for sleep anxiety ranged between 4-8and 6-11 with the mean of 5.96+_1,456 and 8.36+_ 1.290 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for daytime sleepiness ranged between 6-9 and 10-17 with the mean of 7.38+_1,141 and 13.42+_ 1.875 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for night waking ranged between 3-5 and 4-8 with the mean of 3.94+_0,867 and 5.64+_ 1.225 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for sleep disordered breathing ranged between 3-4 and 4-9 with the mean of 3.58+_0,499 and 6.02+_ 1.317 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for parasomnias ranged between 7-10 and 10-18 with the mean of 8.36+_1,045 and 13.36+_ 1.849 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for amount of sleep each night ranged between 10-12 and 5-12 with the mean of 11.040+_0,832 and 8.623+_ 1.483 for controls and cases groups respectively with statistical significant difference between the two groups.
• Score for amount of sleep each day ranged between 2-3 and 3-9 with the mean of 2.56+_0,501 and 5.282+_ 1.696 for controls and cases groups respectively with statistical significant difference between the two groups