Comparative analysis of the prevalence and structure of night sleep disorders in children with neurodevelopmental disorders in wartime and peacetime

Abstract

The problem of sleep disorders in children is one of the most urgent in the practice of a pediatrician and has become especially acute during wartime, given the chronic effects of a significant number of stressors. The need to develop practical recommendations for improving the quality of sleep in children during wartime necessitated a comparative study of the frequency and structure of sleep disorders in children during wartime and peacetime. Purpose - to determine the frequency and structure of nighttime sleep disorders in children with neurodevelopmental disorders and healthy children in wartime and peacetime. Materials and methods. An online survey of parents of 529 children aged 1-7 years (26.8% of healthy children and 73.2% of children with neurodevelopmental disorders) was conducted in 2022 during wartime. A survey of parents of 1352 children under the age of 7 was conducted in 2002 in peacetime (as part of the Family and Children of Ukraine project), with a case-control comparison. Results. The overall prevalence of nighttime sleep disorders among all children in wartime was 93.6% in healthy children and 94.8% in children with neurodevelopmental disorders. Difficulties falling asleep were noted in 51.4% of healthy children and 56.8% of children with neurodevelopmental disorders; frequent nighttime awakenings - in 35.9% and 39.0% of children, respectively. Sleep disorders: snoring - in 16.2% and 18.9% of children; apnoea - in 9.9% and 14.9% of children. Parasomnias: night terrors - in 19.7% and 18.6% of children; sleepwalking - in 2.8% and 4.4% of children. Comparison of the frequency of nighttime sleep disorders in healthy children in peacetime (2002) and wartime (2022): half of healthy children had difficulty going to bed (51.4% vs. 47.2%); early waking (49.8% vs. 12.7%); frequent waking at night (47.3% vs. 35.9%); snoring (33.6% vs. 16.2%); increased daytime sleepiness - 5 times more often in 2002 (30.3% vs. 6.3%); every fourth child has nightmares (25.6% vs. 26.8%); prolonged falling asleep (23.5% vs. 51.4% in 2022). Conclusions. The overall prevalence of nighttime sleep disorders among all children in wartime was 94.5%. In children with neurodevelopmental disorders, early awakenings (29.2% vs. 12.7%), sleep apnoea (14.9% vs. 9.9%), increased daytime sleepiness (14.9% vs. 6.3%), and catalepsy (8.3% vs. 4.2%) were more common compared to healthy children. In wartime, the incidence of early wake-ups (49.8% vs. 12.7% in 2022), snoring (33.6% vs. 16.2% in 2022), and increased daytime sleepiness (30.3% vs. 6.3% in 2022) decreased among healthy children, but the incidence of falling asleep problems increased by 2 times (51.4% vs. 23.5% in the 2002). Children with neurodevelopmental disorders are a more vulnerable group that reacts negatively to the stressful conditions of martial law by increasing the frequency of nighttime sleep disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.