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VOLUME 33, ISSUE 02

SLEEP AND COGNITION IN CHILDREN WITH JUVENILE ARTHRITIS
Sleep Disturbance, Daytime Sleepiness, and Neurocognitive Performance in Children with Juvenile Idiopathic Arthritis

Teresa M. Ward, PhD, RN1; Kristen Archbold, PhD, RN2; Martha Lentz, PhD, RN1; Sarah Ringold, MD3; Carol A. Wallace, MD3; Carol A. Landis, DNSc, RN1

1Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA; 2Practice Division, College of Nursing, University of Arizona, Tucson, AZ; 3Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA



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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.
Keywords: Juvenile idiopathic arthritis, polysomnography, neurobehavioral performance, daytime sleepiness

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