The temporal and bi-directional relationship between physical activity and sleep in ambulatory children with cerebral palsy

PurposeExploring the temporal and bi-directional relationship between device-based measures of physical activity and sleep in ambulatory children with cerebral palsy (CP).Materials and Methods24-hour activity data were collected from children with CP (n = 51, 43% girls, mean age (range); 6.8 (3-12) years; Gross Motor Function Classification System levels I to III). Nocturnal sleep parameters and daily physical activity were measured for seven consecutive days and nights using ActiGraph GT3X accelerometers. Linear mixed models were constructed to explore the relationships between sleep and activity.ResultsLight and moderate-to-vigorous activity were negatively associated with sleep efficiency (SE) (resp. p = 0.04, p = 0.010) and total sleep time (TST) (resp. p = 0.007, p = 0.016) the following night. Sedentary time was positively associated with SE and TST the following night (resp. p = 0.014, p = 0.004). SE and TST were positively associated with sedentary time (resp. p = 0.011, p = 0.001) and negatively with moderate-to-vigorous physical activity (resp. p < 0.001, p = 0.002) the following day. Total bedtime and TST were negatively associated with light physical activity (resp. p = 0.046, p = 0.004) the following day.ConclusionsThe findings from this study suggest that ambulatory children with CP may not sleep better after physical activity, and vice versa, indicating that the relationship is complex and needs further investigation.

Automated summary

The study explores the temporal and bi-directional relationship between physical activity and sleep in ambulatory children with cerebral palsy. Data on 24-hour activity and sleep were collected using ActiGraph GT3X accelerometers. The findings indicate a negative association between light and moderate-to-vigorous activity and sleep efficiency and total sleep time the following night, and a positive association between sedentary time and sleep efficiency and total sleep time the following night. Sleep efficiency and total sleep time were positively associated with sedentary time and negatively with moderate-to-vigorous physical activity the following day. Total bedtime and total sleep time were found to be negatively associated with light physical activity the following day. In conclusion, the study suggests a complex relationship between physical activity and sleep in ambulatory children with cerebral palsy, which requires further investigation.