GANGGUAN TIDUR PADA ANAK DENGAN PALSI SEREBRAL DAN FAKTOR - FAKTOR YANG MEMENGARUHI

SARI WHARDANI MP, dr. Retno Sutomo, Ph.D, Sp.A(K).; Prof. dr. Sunartini, Ph.D, Sp.A(K) s

2019 | Tesis | MAGISTER ILMU KEDOKTERAN KLINIS

Latar belakang: Gangguan tidur merupakan suatu kondisi adanya gangguan dalam jumlah, atau waktu tidur seseorang. Anak yang mempunyai risiko mengalami gangguan tidur terutama yang memiliki penyakit kronis atau hambatan perkembangan neurologik berat seperti palsi serebral. Tujuan: Mengetahui prevalensi gangguan tidur dan faktor-faktor yang mempengaruhi gangguan tidur pada anak dengan palsi serebral usia 4-10 tahun. Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang (cross sectional) pada anak palsi serebral usia 4-10 tahun, pasien yang memiliki penyakit kronis (kardiovaskular, keganasan, penyakit paru obstruktif kronis, diabetes mellitus) dieksklusi dari penelitian. Subyek penelitian diambil secara consecutive sampling. Data diambil berupa data primer (data demografi, intensitas fisioterapi jika dilakukan di luar RSUP Dr. Sardjito, kebiasaan sebelum tidur dan kuisioner gangguan tidur). Data sekunder diambil dari rekam medis untuk mengetahui data-data lain (jenis palsi serebral, derajat keparahan fungsi motorik, ada atau tidaknya epilepsi, intensitas fisioterapi yang dilakukan di RSUP Dr. Sardjito, obat-obatan epilepsi, antispastik dan obat-obatan lain yang mempengaruhi tidur). Gangguan tidur dinilai dengan childrens sleep habit questionnaire (CSHQ). Hasil: Dari 75 subyek, gangguan tidur ditemukan pada 64 anak (85%). Jenis gangguan tidur terbanyak yaitu bedtime resistance (66%). Berdasarkan analisis multivariat faktor-faktor yang mempengaruhi gangguan tidur yatu palsi serebral tipe spastik quadriplegi OR 3,63. IK 95% 1,82 15,94) dan adanya epilepsi OR 7,82, IK 95% (1,53-39,84). Kesimpulan: Prevalensi gangguan tidur pada anak palsi serebral yaitu 85%, dengan jenis gangguan tidur terbesar yaitu bedtime resistance. Tipe spastik quadriplegi dan adanya epilepsi merupakan faktor yang mempengaruhi gangguan tidur pada anak dengan palsi serebral usia 4-10 tahun.

Background: Sleep disorder is a condition when there is a disturbance in amount or duration of sleep. Children who are risk of experiencing sleep disorders are those who especially have chronic diseases or severe neurological developmental delay such as cerebral palsy. Objective: To determined the prevalence and associated factors of sleep disorders among children aged 4-10 years children with cerebral palsy. Methods: We conducted an observational analytic study with cross sectional design in children aged 4-10 years old who has been diagnosed as having cerebral palsy. Participants were recruited consecutively sampling and those who suffer from chronic diseases (cardiovascular, malignancy, chronic obstructive pulmonary disease, and diabetes melitus) were excluded from this study. Primary data such as patients demographic, the intensity of physiotherapy outside Dr. Sardjito General Hospital, habits before going to sleep, and sleep disorder questionnaire were undertaken. Secondary data was obtained from medical records to find the other supplementary data (type of cerebral palsy, severity of motor function impairment, the presence of epilepsy, intensity of physiotherapy performed at Dr. Sardjito General Hospital, antiepileptic and antispastic drugs and other drugs that affect sleep). Sleep disorders were assessed by the children Results: Among 75 subjects, sleep disorder was found in 64 children (85%). Mostly the sleep disorders was bedtime resistance (66%). Based on multivariate analysis, spastic quadriplegic of cerebral palsy (OR 3.63. 95% CI 1.82 15.94) and the presence of epilepsy (OR 7.82, 95% CI 1.53-39.84) were associated with sleep disorder in children 4-10 years old with cerebral palsy. Conclusion: The prevalence of sleep disorder in children with cerebral palsy was 85%, the most common type of sleep disorders was bedtime resistance. Spastic quadriplegic and the presence of epilepsy were associated with sleep disorder in children 4-10 years old with cerebral palsy.

Kata Kunci : gangguan tidur, anak, palsi serebral, CSHQ, sleep disorder, children, cerebral palsy