Comparative Assessment of Sleep Disorders in Children and Adolescents with and without Cystic Fibrosis

Background: Cystic fibrosis (CF) is a chronic and the most common autosomal recessive disorder caused by mutations in the CFTR gene. Sleep disorders are prevalent among patients due to the mechanism of the disease. Objectives: The aim of this study was to investigate and compare sleep disorders in children and adolescents with CF and without CF. Methods: In this case-control study, 52 children aged 4 – 16 years with confirmed CF and 52 healthy controls were recruited from the Children’s Medical Center Hospital in Tehran, Iran, between January and February 2024. Sleep disturbances were assessed using the validated Persian version of the Children’s Sleep Habits Questionnaire (CSHQ), completed by parents. Demographic and clinical data were collected, and statistical analyses included independent t-tests, chi-square tests, and logistic regression, adjusting for weight and BMI. Results: Children with CF had significantly higher total CSHQ scores (mean ± SD: 51.05 ± 5.20) than healthy controls (47.85 ± 5.05; P = 0.002), indicating a greater prevalence of sleep disturbances. The CF group showed significantly higher rates of bedtime resistance, delayed sleep onset, night wakings, parasomnias, and daytime sleepiness. After adjusting for weight and BMI, children with CF had nearly five times higher odds of having a sleep disorder (adjusted OR: 4.89, 95% CI: 1.95 – 12.27; P < 0.001). Clinical symptoms such as cough, shortness of breath, and gastrointestinal complications were also more prevalent in the CF group. Conclusions: This study demonstrates that Iranian children and adolescents with CF experience a substantially higher prevalence and severity of sleep disorders compared to healthy controls. Routine screening and management of sleep problems should be integrated into comprehensive CF care, as addressing them may improve overall health-related quality of life.