Abstract Body (Do not enter title and authors here): Introduction: Sleep problems are common during adolescence. Additional impacts from congenital heart disease (CHD) may contribute to negative outcomes. Studies among adolescents with CHD have described a link between diagnosed sleep disorders, cognitive challenges, cardiovascular risk factors, and mental health problems. Less is known about the association between subjective sleep problems, cognitive function, and general health.
Research Question: What are the associations between sleep problems (quality, disturbance, daytime sleepiness), cognitive function, and general health among adolescents with CHD?
Methods: Adolescents with CHD (n = 87; age 13-19 years) were recruited via the Children’s Hospital of Philadelphia electronic health record system. General health, cognitive functioning, and sleep disturbances were assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric short form measures. Sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD). PROMIS and PSQI cut points were used to classify scores as within or above normal limits. Spearman’s rank correlation assessed bivariate correlations among key measures. Wilcoxon rank-sum test and the Kruskal-Wallis rank-sum test compared mean age across CHD severity, sex, and age groups. Chi-square and Fisher’s exact tests evaluated group differences in sex, CHD severity, and age based on PROMIS and PSQI cut points.
Results: Nearly 39% of adolescents scored above the normal limit on PROMIS Global Health (24%); Cognition (37%) and Sleep Disturbance (39%). A majority also scored above normal on the PSQI (62%). Mean ESS-CHAD scores indicated average levels of daytime sleepiness (6.6 ± 4.0). Sleep disturbance was negatively correlated with cognition (r=-0.28) and global health (r=-0.47), and positively with ESS-CHAD (r=0.27) and PSQI (r=0.59) (p<0.05). No significant group differences were observed by CHD severity, age, or gender.
Conclusion: Poor sleep was significantly associated with decreased cognition and general health among adolescents with CHD, with no significant differences across age, sex, and CHD severity. These findings highlight the prevalence of sleep problems, their association with cognitive function and overall health, and underscore the need for further investigation among adolescents with CHD.