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Werner S, Doerfel C, Biedermann R, Lorenz M, Rasche M, Proquitté H, Newman L, Vilser D. The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID. CHILDREN 2022; 9:children9091419. [PMID: 36138727 PMCID: PMC9497557 DOI: 10.3390/children9091419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/19/2022]
Abstract
Acute SARS-CoV-2 infections in children and adolescents are usually mild. However, they can suffer from ongoing symptoms, generally referred to as long COVID. Sleep disorders are one of the most frequent complaints in long COVID although precise data are missing. We assessed the sleep behavior of children and adolescents who presented at our outpatient clinic between January 2021 and May 2022 with the Children’s Sleep Habits Questionnaire (CSHQ-DE). We compared the sleep behavior at three different time points: pre-COVID-19; post-COVID-19 at the initial presentation; and post-COVID-19 at re-presentation. Data from 45 patients were analyzed. Of those, 64% were female and the median age was 10 years (range: 0–18 years). Asymptomatic or mild COVID-19 disease was experienced in 89% of patients; 11% experienced moderate disease. The initial presentation occurred at a median of 20.4 weeks (6 weeks–14 months) after the infection. The CSHQ-DE score increased significantly from pre-COVID-19 (45.82 ± 8.7 points) to post-COVID-19 (49.40 ± 8.3 points; p ≤ 0.01). The score then normalized at re-presentation (46.98 ± 7.8; p = 0.1). The greatest changes were seen in the CSHQ-DE subscale score “daytime sleepiness”. Our data showed that children and adolescents with long COVID often suffer from sleep disturbances. For most children and adolescents, these sleep disorders decreased over time without any further medical intervention aside from a basic sleep consultation.
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Affiliation(s)
- Sarah Werner
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Claus Doerfel
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Richard Biedermann
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Michael Lorenz
- Respiratory, Allergy and Cystic Fibrosis Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Marius Rasche
- Respiratory, Allergy and Cystic Fibrosis Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Hans Proquitté
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Lars Newman
- Cardiology Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Daniel Vilser
- Cardiology Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
- Correspondence:
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Abstract
The Children's Sleep Comic is a standardized self-report questionnaire for assessing insomnia in children ages 5-11 years. The goal of the present study is to introduce a revised version of this measure and to present psychometrics and a cut-off score. Therefore, the revised Children's Sleep Comic, the Sleep Self Report, the Children's Sleep Habits Questionnaire, and the Child Behavior Checklist were applied to a sample of 393 children and their parents. Of the parents who participated voluntarily, a subsample (n = 176) was interviewed on the phone to diagnose their children with sleep disorders according to the International Classification of Sleep Disorders, if applicable. The results indicated that the Children's Sleep Comic is a reliable self-rating instrument for diagnosing childhood insomnia. Internal consistency was α = 0.83; and convergent and divergent validity were adequate. The child-friendly format can foster a good therapeutic relationship, and thus establish the basis for successful intervention.
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