Sleep, Behavioral, and Cognitive Complaints in Children with Neurofibromatosis Type 1: A Public Health Challenge
Authors:   Federal University of Rio Grande do Norte (UFRN), Department of Psychology, Postgraduate Program in Psychobiology, AMBSONO Sleep Clinic – AMBNAP-Children's Narcolepsy and Sleep Apnea Outpatient Clinic - Onofre Lopes University Hospital - Natal - Rio Grande do Norte - Brazil, Almondes Katie Moraes , Medeiros Débora da Silva ,   Federal University of Rio Grande do Norte (UFRN), AMBSONO Sleep Clinic - Onofre Lopes University Hospital - Natal - Rio Grande do Norte – Brazil, Azevedo Julianna Pinto ,   Federal University of Rio Grande do Norte (UFRN), Department of Psychology - Natal - Rio Grande do Norte – Brazil, Camilo Vinícius Ricardo ,   Federal University of Rio Grande do Norte (UFRN), Department of Psychology - Natal - Rio Grande do Norte – Brazil, Raﬁhi-Ferreira Renatha El ,   University of São Paulo (USP), Institute of Psychiatry - São Paulo - São Paulo – Brazil, Rodrigues Luiz Oswaldo ,   Federal University of Minas Gerais (UFMG), Clinical Hospital, Neuroﬁbromatosis Reference Center- Belo Horizonte - Minas Gerais - Brazil
Published: January 2024

Abstract Background: Neurofibromatosis type I (NF1) is a genetic and neurodevelopmental condition impacting the peripheral nervous system. Predominant clinical features include "café au lait" spots, neurofibromas, and cognitive challenges. While some clinical reports suggest a link between NF1 and alterations in sleep, there is a lack of studies exploring this connection specifically in children. This becomes crucial, given that sleep significantly influences a child's neurobehavioral, neurocognitive, and psychosocial development. Objective: To describe sleep, cognitive, and behavioral complaints in Brazilian children diagnosed with Neuroﬁbromatosis type 1. Methods: Parents of children within the age range from 1 to 12 years old answered an online questionnaire composed of 24 questions related to sleep habits, sleep patterns, and cognitive and behavioral complaints. Results: Data was collected from 41 children, who were categorized between preschoolers (32%) and school-aged (68%). 63% of the entire sample reported sleep complaints. 66% of the children slept less than 10 hours a day, 26% of them being preschoolers and 74% school-aged. 85% of the children used electronics devices at night, and more than half (54%) of the sample had more than 2 hours of daily screen time. 66% of the children had a late bedtime. Easy crying (31%) was the most reported behavioral complaint in preschoolers, and anxiety (32%) was more prevalent in school-aged children. Alterations in attention and focus (44%) was the most frequent cognitive issue in the entire sample. Conclusion: This is the ﬁrst study carried out in Brazil that assesses sleep, behavioral and cognitive complaints, and sleep patterns in children with NF1. It was reported that children with NF1 have signiﬁcant sleep complaints and insuﬃcient sleep duration. Additionally, behavioral, and cognitive complaints were widely reported. We reinforce the relevance of sleep assessment during routine clinical examination of patients with NF1. Keywords: Neuroﬁbromatosis 1, Child, Sleep, Cognition, Behavior.