Sleep Disturbance, Daytime Sleepiness, and Neurocognitive Performance in Children with Juvenile Idiopathic Arthritis

Abstract

STUDY OBJECTIVES: To compare daytime sleepiness and neurobehavioral performance in children with active and inactive juvenile idiopathic arthritis (JIA), and explore relations among measures of sleep disturbance, daytime sleepiness, and neurobehavioral performance. DESIGN: Cross-sectional, comparison. SETTING: A university-based research sleep laboratory. PARTICIPANTS: Seventy (70) children 6-11 years of age with active or inactive JIA. MEASUREMENTS AND RESULTS: Self-reported daytime sleepiness, multiple sleep latency tests (MSLTs), and computerized neurobehavioral performance test scores were obtained after 2 nights of polysomnography. Children with active disease (mean physician global rating score = 2.9 +/- 1.9 SD) showed shorter mean MSLT latency (15 +/- 6.0 min) than those with inactive disease (16.5 +/- 5.5 min, P < 0.03). Scores on neurobehavioral performance tests showed no group differences. However, number of wake bouts predicted sustained visual attention (rapid visual processing, P < 0.05) and apnea hypopnea index (AHI) predicted reaction time (P < 0.0001), after controlling for age, IQ, medication, and disease status. CONCLUSION: Indices of sleep disturbance were associated with validated tests of neurobehavioral performance in JIA, regardless of disease activity. Additional research is needed about the extent of sleep disturbances in relation to neurocognitive performance in JIA and compared to healthy children.

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