The COVID-19 pandemic most likely did not exacerbate sleep problems in the majority of children with neurodevelopmental disorders with insomnia symptoms, according to parental perceptions. These are the findings of a study published in the Journal of Pediatric Health Care.
Children with neurodevelopmental disorders often report sleep disturbances, which have been associated with poor daytime functioning. Alterations to daily routines have the potential to contribute to or exacerbate sleep disturbances. As the COVID-19 pandemic has affected many aspects of life, researchers sought to evaluate whether changes associated with COVID-19 have contributed to sleep-related problems among school-aged children with neurodevelopmental disorders.
Researchers from the Dalhousie University in Canada recruited 100 parents of a child with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), fetal alcohol spectrum disorder (FASD), or cerebral palsy (CP) and symptoms of insomnia to complete an online survey between April 2020 and March 2021. The survey included questions about demographics, perceptions about the impact of COVID-19, and associated sleep changes.
The children had ADHD (70%), ASD (23%), FASD (5%), and CP (2%). Overall, children were aged mean 8.80 (standard deviation [SD], 2.00) years and 25% were girls.
No changes to sleep associated with COVID-19 were reported by 66% of parents. The parents who reported changes thought the pandemic worsened symptoms (30%) or improved symptoms (4%).
Among the parents reporting worsening sleep habits, 21 of the children had ADHD, 8 had ASD, and 1 had FASD.
The type of worsening sleep symptoms were difficulties falling or staying asleep and a shift in bedtime and waking time. The parents thought the reason for worsening sleep symptoms was an increase in anxiety, stress, and worry. Other parents were concerned with changes to routines which caused their child to burn less energy during the day, leading to restlessness at night.
The parents reporting sleep improvements in their children had a child with ADHD (n=3) and FASD (n=1).
Improved sleep reporting was endorsed to be due to a reduction in stress and letting parents letting their child wake up naturally in the morning due to a relaxed timetable.
This study may not be generalizable, as most children had ADHD and ASD.
Although the COVID-19 pandemic did not decrease sleep quality in most children with neurodevelopmental disorders who already experienced sleep problems, it did have a negative impact on 30% of children and a positive impact on 4% of children, the researchers noted.
“Healthcare providers working with families of children with NDDs [neurodevelopmental disorders] (especially ADHD and ASD) experiencing sleep problems should be aware of the potential impact that future waves of the pandemic or restrictions in day-to-day activities may have on their sleep,” they concluded.
Pizzo A, Keys E, Corkum P. Parental perceptions of the impact of the COVID-19 pandemic on the sleep of children with neurodevelopmental disorders. J Pediatr Health Care. Published online September 26, 2022. doi:10.1016/j.pedhc.2022.09.010