(31) Sleep Disturbance & School Engagement In Children With Cystic Fibrosis During The COVID-19 Pandemic

Thursday, November 3, 2022

12:45 PM – 1:25 PM ET

Presenting Author(s)

Benjamin L. Wisniewski, M.D.

Pediatric Sleep Medicine Fellow
Cincinnati Children's Hospital Medical Center
Columbus, Ohio, United States

Co-Author(s)

KS

Krista Swegheimer, CCRP

United States
TB

Thomas Boat, MD

Professor
Cincinnati Children's Hospital/University of Cincinnati College of Medicine, United States
Michelle Hjelm, MD

Assistant Professor
Cincinnati Children's Hospital/University of Cincinnati College of Medicine
Cincinnati, Ohio, United States

Background:

Alterations in sleep remain important barriers to improved quality-of-life for children with chronic diseases, and especially for those in vulnerable patient populations, such as children with cystic fibrosis (CF). Disrupted sleep and diminished sleep quality have an increased prevalence in children with CF even when corrected for measures of disease severity. Parents of children with CF have also been shown to have insufficient sleep duration and daytime sleepiness that positively correlates with the sleep disturbances in their children [1.] There are currently no published studies in the literature that describe the relationship between sleep disturbance and school engagement in pediatric CF populations during the COVID-19 pandemic.

Methods:

A pilot prospective cross-sectional observational study in school-aged children with CF was initiated at Cincinnati Children’s Hospital Medical Center in July, 2021 with planned ongoing enrollment until May, 2022. A COVID-19 specific school engagement questionnaire was developed and data were collected. Patient diagnoses, medications, demographics, Epworth Sleepiness Score for Children & Adolescents (ESS-CHAD), Pediatric Insomnia Severity Index (PISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and academic report card data are being recorded. Descriptive statistics were performed.

Results:

23 school-aged children with CF have been enrolled. 11 children have available data and range from 5 to 18 years-of-age (Median Age: 10 years; 63.6% Female). 72.7% (n=8) of children had an insufficient sleep duration when compared the American Academy of Sleep Medicine consensus guidelines. Mean ESS-CHAD is 7 (Range 2-12). 18.2% (n=2) of subjects meet criteria for subjective mild excessive daytime sleepiness. Median range of absences during a given academic year were between 6 to 10 days. Subjects participated in a variety of learning methods during the past academic year: virtual (n=6), in-person (n=4), hybrid (n=4), home-school (n=1). 45.5% (n=5) reported being afraid of their child becoming sick or contracting COVID-19 due to school-related activities. 18.2% (n=2) believe that the COVID-19 pandemic has worsened their child’s sleep and negatively impacted their academic performance. 100% (n=11) expressed that their child’s academic performance was either stable or improving following a transition to mostly in-person instruction this academic year.

Conclusions:

Preliminary data from ongoing enrollment in this pilot study suggests that the COVID-19 pandemic has negatively impacted sleep and school engagement in some children with CF. Academic performance subjectively improved following a return to mostly in-person instruction. Sleep disturbance may be an underappreciated aspect of the pediatric CF care model. We continue to have limited understanding of the approaches needed for sleep-related screening, diagnosis, and clinical management. Additional data and analyses will be reported at the North American Cystic Fibrosis Conference 2022 meeting.

Acknowledgements:

Cystic Fibrosis Foundation: 4th Year Clinical Fellowship Award (WISNIE21D0); Cincinnati Children’s Research Foundation.

References:

[1.] Byars KC, Chini B, Hente E, Amin R, Boat T. Sleep disturbance and sleep insufficiency in primary caregivers and their children with cystic fibrosis. J Cyst Fibros. 2020;19(5):777-782.