Sleep and development in cerebral palsy

Sleep plays a critical role in child and adolescent development, supporting physical growth, cognition, and emotional regulation. Children with cerebral palsy (CP) experience higher rates of sleep disturbances compared to children without CP, including difficulties initiating and maintaining sleep, sleep disordered breathing, and excessive daytime sleepiness. These disruptions can further hinder developmental progress. While sleep research has highlighted the importance of sufficient quality sleep for cognitive and behavioral growth in typically developing children, the complexities of CP make it challenging to establish a clear link between sleep disturbances, comorbidities, and developmental outcomes. The severity of clinical phenotype and comorbidities contribute to sleep difficulties in CP. Despite the critical need for objective sleep assessments like EEG-polysomnography, most research relies on caregiver reports, which are not always validated for this population. The current body of research also faces limitations, including small sample sizes and a lack of longitudinal studies on the long-term impact of sleep disturbances in children with CP. Future research should prioritize large-scale longitudinal and comparative studies and utilize objective tools to improve early diagnosis and guide the development of therapeutic interventions, ultimately enhancing developmental outcomes during the critical stages of neuroplasticity in early childhood.