TY - JOUR
T1 - Association between sleep disturbances with neurodevelopmental problems and decreased health-related quality of life in children with fontan circulation
AU - Knobbe, Kirstin
AU - Partha, Meghana
AU - Seckeler, Michael D.
AU - Klewer, Scott
AU - Hsu, Chiu Hsieh
AU - Edgin, Jamie
AU - Morgan, Wayne J.
AU - Provencio-Dean, Natalie
AU - Lopez, Silvia
AU - Parthasarathy, Sairam
AU - Combs, Daniel
N1 - Funding Information:
Dr Combs reports a grant from the LuMind-IDSC foundation as well as prior funding from the American Academy of Sleep Medicine Foundation. Dr Edgin reports grants from the LuMind Foundation and the National Institutes of Health. Dr Morgan reports funding from NIH, the Cystic Fibrosis Foundation as well as consultant fees from the Cystic Fibrosis Foundation and speaker honoraria from the American Thoracic Society and the American College of Chest Physicians. These relationships are unrelated to this paper. Dr Parthasarathy reports grants from the National Institutes of Health, American Academy of Sleep Medicine Foundation, Patient Centered Outcomes Research Institute, personal royalty fees from UpToDate Inc, and consultant fees from Jazz pharmaceuticals. Outside the submitted work, Dr Parthasarathy has a patent UA 14-018 U.S.S.N. 90 61/884,654; PTAS 502570970 (home breathing device) issued. The remaining authors have no disclosures to report.
Funding Information:
Funding for this project was provided by an American Heart Association Career Development Award (19CDA34740005), National Institutes of Health (HL151254) and a University of Arizona Health Sciences Career Development Award to Dr Combs as well as HL126140 and OT2HL156812 to Dr Parthasarathy. The Fontan Cross-sectional study was funded by HL068270, HL068269, HL068292, HL068290, HL068288, HL068285, HL068281 and HL068279 from the NIH/NHLBI. Role of the sponsors: The sponsors (American Heart Association, National Institutes of Health and University of Arizona Health Sciences) had no input into study design or manuscript development.
Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2021/11/2
Y1 - 2021/11/2
N2 - BACKGROUND: Children with Fontan circulation are known to be at increased risk for neurodevelopmental problems and decreased health-related quality of life (HRQOL), but many factors that may contribute to this risk are unknown. Sleep disturbances may be one previously unidentified factor that contributes to this risk. METHODS AND RESULTS: We analyzed data from the Pediatric Heart Network Fontan cross-sectional study to evaluate associations between a parent or child report of sleep disturbance with reported neurodevelopmental concerns and HRQOL in 558 children with Fontan circulation. Parent-reported sleep disturbance was present in 11% of participants and child-reported sleep disturbance was present in 15%. Parent-reported sleep disturbance was associated with a significantly higher risk of attention problems, anxiety, depression, behavioral problems, and developmental delay (P<0.001 for all). Similarly, parent-reported disturbance was associated with decreased HRQOL on both parent and child-reported HRQOL (P<0.001 for most domains). Child-reported sleep disturbances were associated with increased odds of anxiety, depression, and attention problems as well as worse HRQOL. These associations were present even after adjustment for cardiac, demographic, and socioeconomic factors that may affect HRQOL and neurodevelopmental status. CONCLUSIONS: Sleep disturbances in children with Fontan circulation are associated with an increased risk of neurodevelop-mental problems as well as reduced HRQOL compared with those without sleep disturbance. Better understanding of sleep disturbances is needed in children with Fontan circulation, as sleep disturbances may represent a reversible cause of neu-rodevelopmental problems and decreased HRQOL in this population.
AB - BACKGROUND: Children with Fontan circulation are known to be at increased risk for neurodevelopmental problems and decreased health-related quality of life (HRQOL), but many factors that may contribute to this risk are unknown. Sleep disturbances may be one previously unidentified factor that contributes to this risk. METHODS AND RESULTS: We analyzed data from the Pediatric Heart Network Fontan cross-sectional study to evaluate associations between a parent or child report of sleep disturbance with reported neurodevelopmental concerns and HRQOL in 558 children with Fontan circulation. Parent-reported sleep disturbance was present in 11% of participants and child-reported sleep disturbance was present in 15%. Parent-reported sleep disturbance was associated with a significantly higher risk of attention problems, anxiety, depression, behavioral problems, and developmental delay (P<0.001 for all). Similarly, parent-reported disturbance was associated with decreased HRQOL on both parent and child-reported HRQOL (P<0.001 for most domains). Child-reported sleep disturbances were associated with increased odds of anxiety, depression, and attention problems as well as worse HRQOL. These associations were present even after adjustment for cardiac, demographic, and socioeconomic factors that may affect HRQOL and neurodevelopmental status. CONCLUSIONS: Sleep disturbances in children with Fontan circulation are associated with an increased risk of neurodevelop-mental problems as well as reduced HRQOL compared with those without sleep disturbance. Better understanding of sleep disturbances is needed in children with Fontan circulation, as sleep disturbances may represent a reversible cause of neu-rodevelopmental problems and decreased HRQOL in this population.
KW - Cognitive impairment
KW - Fontan procedure
KW - Quality of life
KW - Single ventricle
KW - Sleep
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U2 - 10.1161/JAHA.121.021749
DO - 10.1161/JAHA.121.021749
M3 - Article
C2 - 34668394
AN - SCOPUS:85120788179
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 21
M1 - e021749
ER -